2
Leading the charge on MDROs Multi- Drug Resistant Organisms bioMérieux S.A. 69280 Marcy l’Etoile France Tel.: 33 (0)4 78 87 20 00 Fax: 33 (0)4 78 87 20 90 www.biomerieux.com www.biomerieux-diagnostics.com A Global Challenge As the gap widens between the rising number of MDRO infections and the development of new antibiotics to treat them, “Superbugs” have become one of healthcare’s biggest threats. Rapid diagnostic methods and surveillance are some of the most valuable tools in preventing the spread of resistance. (1) Screening at-risk patients ** , as part of an Infection Control program is an effective measure to contain the spread of MDROs. (2) Reducing the emergence and spread of antimicrobial resistance is a global challenge – requiring strong and smart actions. (1) Antibiotic Resistance: An Ecological Perspective on an Old Problem. A Report of the American Academy of Microbiology. 2009. (2) Centers for Disease Control and Prevention. Management of Multi-Resistant Organisms in Health care setting. Atlanta, CDC. 2006. (3) Identification and screening of carbapenemase-producing Enterobacteriaceae. P. Nordmann and the European Network on Carbapenemases. Clinical Microbiology and Infection 2012 10.1111/j.1469-0691.2012.03815. (4) Global Spread of Carbapenemase producing Enterobacteriaceae. P. Nordmann, Emerging Infectious Diseases. www.cdc.gov/eid • Vol. 17, No. 10, October 2011. (5) Rapid evolution and spread of carbapenemases among Enterobacteriaceae in Europe. R. Canto´n ; the European Network on Carbapenemases. Clinical Microbiology and Infection 2012 10.1111/j.1469-0691.2012.03821. (6) Centers for Disease Control and Prevention - Guidance for Control of infections with carbapenem resistant or carbapenemase-producing Enterobacteriaceae in acute care facilities - MMWR, 2009, 58(10): 256-260. (7) Perry J. et al. Journal of Antimicrobial Chemotherapy, 2011, ISSN:1460-2091. (8) Vrioni G. et al. J. Clin. Microbiol. 2012, 50:1841-1846. (9) Bereksi N. et al. Poster 1718 – London 2012 – 22 nd ECCMID. (10) Paterson D. et al. Clin Microbio Rev. 2005, 18:657-86. (11) Glupczynski Y. et al. J Clin Microbiol. 2007, 45:501-505. (12) Wenger A. et al. Poster 90. 65th annual Assembly of SSM Lausanne. (13) Antibiotic Resistance: An Ecological Perspective on an Old Problem. A report of the American Academy of Microbiology. 2009. (14) Coia JE. et al. J Hosp Infect. 2006, 635, S1-S44. (15) Van Hoecke F. et al. Eur J Clin Microbiol Infect Dis. 2011;30(12):1595-8. (16) Muto CA. et al. Infect. Control. Hosp. Epidemiol 24:362-386. (17) Ledeboern N. et al. J Clin Microbiol. 2007, 45:1556-1560. (18) Laximinarayan R. et al. Clin Infect Dis. 2009, 49:1185-6. (19) Spanu T. et al. J Clin Microbiol. 2012 23. [Epub ahead of print]. (20) Orenga S. et al. Journal of Microbiological Methods. 2009, 79:139-155. Bibliography ** USA only FDA cleared marked products Targeted Solutions FOR SCREENING & ACTIVE SURVEILLANCE With chromID bioMérieux offers you an extensive range of chromogenic media for the simultaneous culture and identification of micro-organisms (20) Over 45 years experience in the fight against Infectious Diseases 11-12 / 9304440/002/GB/B / Document and/or pictures not legally binding. Modifications by bioMérieux can be made without prior notice / BIOMÉRIEUX, the blue logo, chromID, API, Slidex, VITEK, ATB and LyfoCults, VIDAS, Nuclisens Easy Q, DiversiLab, Etest, Vigiguard, VigiAct are used, pending and/or registered trademarks belonging to bioMérieux or one of its subsidiaries or one of its companies / The ATCC Licensed Derivative Emblem, the ATCC Licensed Derivative word mark. The ATCC trademark and trade name and any and all ATCC catalog numbers are trademarks of the American Type Culture Collection / bioMérieux S.A. RCS Lyon 673 620 399 / Photos: C. Ganet, C. Nonhoff, Fotolia / Printed in France / THERA Conseil RCS Lyon B 398 160 242 2012 chromID ® CARBA 2011 chromID ® C. difficile VITEK ® MS Etest ® MBL MP/MPI 2010 chromID ® VRE FDA cleared NucliSENS EasyQ ® KPC (RUO) 2009 chromID ® MRSA FDA cleared NucliSENS EasyQ ® MRSA 2008 Etest ® VIGIguard™ Surveillance and Epidemiology range 2007 DiversiLab ® microbial genotyping system chromID ® ESBL and chromID ® VRE 2005 chromID ® MRSA screening test 2002 NucliSENS EasyQ ® , real-time amplification and detection platform VIGI@act™ epidemiology software 1998 VITEK ® 2 system and Advanced Expert System™ 1981 First SLIDEX ® kit for microbial antigen detection 1979 ATB™ strips for susceptibility testing 1963 Culture Media chromID ® plates and LyfoCults ® Plus Microorganisms chromID CARBA agar ref 43861 20 plates chromID CARBA/chromID OXA-48 agars* ref 414011 20 bi-plates LyfoCults ® Plus K. pneumoniae BAA 1705 (KPC) ref 303479 1 x 2 strains chromID ESBL agar ref 43481 20 plates Biplate BLSE agar ref AEB525770 20 bi-plates LyfoCults ® Plus K. pneumonia ATCC ® 700603™ (ESBL) ref 301247 1 x 2 strains chromID VRE agar ref. 43004/43851** 20 plates chromID ESBL/chromID VRE agars* ref 43470 20 bi-plates LyfoCults ® Plus E. faecalis ATCC ® 51299™ (VanB) ref 301107 1 x 2 strains chromID MRSA agar ref 43451/43841** 20 plates chromID MRSA agar ref 43459 100 plates chromID MRSA/chromID S.aureus agars ref 43466 20 bi-plates LyfoCults ® Plus S. aureus ATCC ® 43300™ (MRSA) ref 301621 1 x 2 strains Additional ranges Brain-heart infusion broth ref 42081 20 tubes Todd Hewitt broth ref 42116 20 tubes Mueller Hinton hyper salted agar* ref AEB521800E 20 plates CLOXA Mueller Hinton agar* ref AEB120291 10 plates 120 x120 mm Molecular biology NucliSENS EasyQ ® MRSA ref. 280115 48 tests NucliSENS EasyQ KPC (RUO) ref 410341 48 tests Research use only Etest ® strips ESBL PM/PML ref 534700 30 strips ESBL CT/CTL ref 532200 30 strips ESBL TZ/TZL ref 532500 30 strips MBL MP/MPI ref 411361 30 strips VITEK ® 2 - VITEK 2 COMPACT – VITEK MS Contact your local bioMérieux representative for availability DiversiLab ® Contact your local bioMérieux representative for availability SLIDEX ® SLIDEX MRSA Detection ref 73117 50 tests www.biomerieux.com/besmart bioMérieux’s portfolio of S.M.A.R.T solutions contributes to the managment of antimicrobial resistance by providing timely actionable results for informed clinical decisions. ** Intensive Care Units, clean surgery, transplantation units, cardio-vascular surgery, orthopedic surgery, geriatrics, long-term care facilities. Previous carriage or infection with MRDO, hospital stay and/or antibiotic exposure within the last year, coming from endemic zones… new new new new new new * For more information consult the instructions for use. Contact your local bioMérieux representative for availability. ATCC ®* :

A Global Challenge.../ The ATCC Licensed Derivative Emblem, the ATCC Licensed Derivative word mark. ... LyfoCults® Plus K. pneumoniae BAA 1705 (KPC) ref 303479 1 x 2 strains chromID

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Leading the charge on MDROsMulti-Drug Resistant Organisms

bioMérieux S.A.69280 Marcy l’EtoileFranceTel.: 33 (0)4 78 87 20 00Fax: 33 (0)4 78 87 20 90www.biomerieux.comwww.biomerieux-diagnostics.com

A Global ChallengeAs the gap widens between the rising number of MDRO infections and the development of new antibiotics to treat them, “Superbugs” have become one of healthcare’s biggest threats.

Rapid diagnostic methods and surveillance are some of the most valuable tools in preventing the spread of resistance. (1)

Screening at-risk patients **, as part of an Infection Control program is an effective measure to contain the spread of MDROs. (2)

Reducing the emergence and spread of antimicrobial resistance is a global challenge – requiring strong and smart actions.

(1) Antibiotic Resistance: An Ecological Perspective on an Old Problem. A Report of the American Academy of Microbiology. 2009.

(2) Centers for Disease Control and Prevention. Management of Multi-Resistant Organisms in Health care setting. Atlanta, CDC. 2006.

(3) Identification and screening of carbapenemase-producing Enterobacteriaceae. P. Nordmann and the European Network on Carbapenemases. Clinical Microbiology and Infection 2012 10.1111/j.1469-0691.2012.03815.

(4) Global Spread of Carbapenemase producing Enterobacteriaceae. P. Nordmann, Emerging Infectious Diseases. www.cdc.gov/eid • Vol. 17, No. 10, October 2011.

(5) Rapid evolution and spread of carbapenemases among Enterobacteriaceae in Europe. R. Canto´n ; the European Network on Carbapenemases. Clinical Microbiology and Infection 2012 10.1111/j.1469-0691.2012.03821.

(6) Centers for Disease Control and Prevention - Guidance for Control of infections with carbapenem resistant or carbapenemase-producing Enterobacteriaceae in acute care facilities - MMWR, 2009, 58(10): 256-260.

(7) Perry J. et al. Journal of Antimicrobial Chemotherapy, 2011, ISSN:1460-2091.

(8) Vrioni G. et al. J. Clin. Microbiol. 2012, 50:1841-1846.

(9) Bereksi N. et al. Poster 1718 – London 2012 – 22nd ECCMID.

(10) Paterson D. et al. Clin Microbio Rev. 2005, 18:657-86.

(11) Glupczynski Y. et al. J Clin Microbiol. 2007, 45:501-505.

(12) Wenger A. et al. Poster 90. 65th annual Assembly of SSM Lausanne.

(13) Antibiotic Resistance: An Ecological Perspective on an Old Problem. A report of the American Academy of Microbiology. 2009.

(14) Coia JE. et al. J Hosp Infect. 2006, 635, S1-S44.

(15) Van Hoecke F. et al. Eur J Clin Microbiol Infect Dis. 2011;30(12):1595-8.

(16) Muto CA. et al. Infect. Control. Hosp. Epidemiol 24:362-386.

(17) Ledeboern N. et al. J Clin Microbiol. 2007, 45:1556-1560.

(18) Laximinarayan R. et al. Clin Infect Dis. 2009, 49:1185-6.

(19) Spanu T. et al. J Clin Microbiol. 2012 23. [Epub ahead of print].

(20) Orenga S. et al. Journal of Microbiological Methods. 2009, 79:139-155.

Bibliography

** USA only FDA cleared

marked products

Targeted Solutions FOR SCREENING & ACTIVE SURVEILLANCE

With chromID bioMérieux offers you an extensive range of chromogenic media for the simultaneous culture and identification of micro-organisms (20)

Over 45 years experience

in the fight against Infectious Diseases

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2012 chromID® CARBA

2011 chromID® C. difficile

VITEK® MS Etest® MBL MP/MPI

2010 chromID® VRE FDA cleared

NucliSENS EasyQ® KPC (RUO) 2009

chromID® MRSA FDA cleared NucliSENS EasyQ® MRSA

2008 Etest®

VIGIguard™ Surveillance and Epidemiology range 2007

DiversiLab® microbial genotyping system chromID® ESBL and chromID® VRE

2005 chromID® MRSA screening test

2002 NucliSENS EasyQ®, real-time amplification and detection platform

VIGI@act™ epidemiology software 1998

VITEK® 2 system and Advanced Expert System™1981

First SLIDEX® kit for microbial antigen detection 1979

ATB™ strips for susceptibility testing 1963

Culture Media

chromID® plates and LyfoCults® Plus MicroorganismschromID CARBA agar ref 43861 20 plateschromID CARBA/chromID OXA-48 agars* ref 414011 20 bi-platesLyfoCults® Plus K. pneumoniae BAA 1705 (KPC) ref 303479 1 x 2 strainschromID ESBL agar ref 43481 20 platesBiplate BLSE agar ref AEB525770 20 bi-platesLyfoCults® Plus K. pneumonia ATCC® 700603™ (ESBL) ref 301247 1 x 2 strainschromID VRE agar ref. 43004/43851** 20 plateschromID ESBL/chromID VRE agars* ref 43470 20 bi-platesLyfoCults® Plus E. faecalis ATCC® 51299™ (VanB) ref 301107 1 x 2 strainschromID MRSA agar ref 43451/43841** 20 plateschromID MRSA agar ref 43459 100 plateschromID MRSA/chromID S.aureus agars ref 43466 20 bi-platesLyfoCults® Plus S. aureus ATCC® 43300™ (MRSA) ref 301621 1 x 2 strains

Additional rangesBrain-heart infusion broth ref 42081 20 tubes Todd Hewitt broth ref 42116 20 tubesMueller Hinton hyper salted agar* ref AEB521800E 20 platesCLOXA Mueller Hinton agar* ref AEB120291 10 plates 120 x120 mm

Molecular biology NucliSENS EasyQ® MRSA ref. 280115 48 testsNucliSENS EasyQ KPC (RUO) ref 410341 48 tests Research use only

Etest® strips ESBL PM/PML ref 534700 30 stripsESBL CT/CTL ref 532200 30 stripsESBL TZ/TZL ref 532500 30 stripsMBL MP/MPI ref 411361 30 strips

VITEK® 2 - VITEK 2 COMPACT – VITEK MSContact your local bioMérieux representative for availability

DiversiLab®

Contact your local bioMérieux representative for availability

SLIDEX®

SLIDEX MRSA Detection ref 73117 50 tests

www.biomerieux.com/besmart

bioMérieux’s portfolio of S.M.A.R.T solutions contributes to the managment of antimicrobial resistance by providing timely actionable results for

informed clinical decisions.

** Intensive Care Units, clean surgery, transplantation units, cardio-vascular surgery, orthopedic surgery, geriatrics, long-term care facilities. Previous carriage or infection with MRDO, hospital stay and/or antibiotic exposure within the last year, coming from endemic zones…

new new

new

new

new

new * For more information consult the instructions for use. Contact your local

bioMérieux representative for availability.

ATCC

®* :

“ “

In some countries, over 60% of Staphylococcus aureus cases in hospital ICUs are now resistant to first-line antibiotics (18)“ “

“The validated Certificate of Compatibility, document shows the compatibility

with complementary bioMérieux tests. www.biomerieux.com/techlib“

MDRO complete offer

ESBL* among the gram-negative bacilli has been

a major concern in hospitals in recent years.(10)

SPECIFICITY – SENSITIVITY - RAPIDITY

> chromID® ESBL agar Chromogenic medium for the screening of ESBL-producing Enterobacteriaceae

Very rapid screening of ESBL in 18-24 hours with ➔ high sensitivity 97.7% (11) ➔ high specificity 98% (11)

defined on clinical specimens (rectal swabs, urines, respiratory specimens)

> biplate BLSE agarSelective medium for the screening of presumptive ESBL Enterobacteriaceae and Multi-Resistant Gram-negative bacilli (12)

defined on stools, rectal swabs, urine and respiratory specimens

VALI

DATED

CO M PAT I B

LE

&VALIDÉ

COMPATIBLE

&

For more information consult the instructions for use. Contact your local bioMérieux representative for availability.

F

VRE - Carrier screening is the most efficient method of controlling VRE. Enterococcus faecium

and Enterococcus faecalis with acquired vancomycin resistance (phenotypes VanA and VanB) are increasingly

responsible for healthcare-associated infections. (16)

RAPIDITY – SIMPLICITY - RELIABILITY

> chromID® VRE agar Chromogenic medium for the screening of

Vancomycin-resistant Enterococci

Direct identification of Enterococcus faecalis (bluish-green) and E. faecium (violet) and identification of Vancomycin-resistant

Enterococci in 24 hours (17), defined on stools and rectal swab specimens

MRSA (Methicillin-resistant Staphylococcus aureus) has become a major public health concern. Screening of

MRSA carriage is recommended by official organisations. (14)

SPECIFICITY – SENSITIVITY - RELIABILITY

> chromID® MRSA agar Chromogenic medium for the screening of Methicillin-resistant

Staphylococcus aureusProvides colony isolation and identification of MRSA in 18-24 hours

Validated for use with nose, throat, perineum, wound, groin specimens (15)

Rapid diagnostic methods and surveillance are some of the most valuable tools

in preventing the spread of resistance (13)

* Extended-spectrum beta-lactamase–producing Enterobacteriacae.

A N E X T E N S I V E P A N E L O F R E A G E N T S T O S C R E E N , I D E N T I F Y , T R A C K A N D P R E V E N T

CARBAPENEMASES are the most powerful beta-lactamases, being able to hydrolyze almost all ß-lactams. They are mostly of the KPC, VIM, IMP, NDM and OXA-48 types. (3) (4) (5)

SPECIFICITY – SENSITIVITY - RAPIDITY

> chromID® CARBA agar Chromogenic medium for the screening of carbapenemase producing Enterobacteriaceae

Very rapid screening of carbapenemase producing Enterobacteriaceae in 18-24 hours (6) with ➔ high sensitivity 97.4% [93.4-99.3] ➔ high specificity 99.7% [98.9-100.0] defined on clinical specimens (stools or rectal swabs) compared to conventional method (7) (8) (9)

E

B

bioMérieux

bioMérieux

NucliSENS EasyQ® Amplification and qualitative detection of genes from bacterial nucleic acid extracts (19)

LyfoCults® Plus Microorganisms for quality control procedures

Etest® Quantitative technique for phenotypically determining the antimicrobial susceptibility

VITEK® 2 Technology VITEK® MS Identification and antimicrobial susceptibility testing

DiversiLab® Characterization to strain level for rapid implementation of infection control measures

SLIDEX® Identification of MRSA by detecting PBP2’ (penicillin-binding protein 2’)

C

A: Klebsiella pneumoniae BAA 1705 - 18 hoursB: E.coli NDM1- 18 hours - Zoom x2C: E.coli CIP 103582 - K.pneumoniae ATCC® 700603™ P. mirabilis ATCC® BAA-896 - 24 hours - Zoom x2

D: Acinetobacter baumanii NCTC® 13301 - OXA-23 - 24 hours - Zoom x1,5E: Image from Mrs. C. Nonhoff, Belgium - Zoom x2F: E.faecium CCUG 36804 E.faecalis ATCC® 51299™ - 48 hours - Zoom x2

A

D