An essential part of the Israeli intervention program aimed to contain the spread of carbapenemase-producing Enterobacterales (CPE) has been the establishment of national surveillance system, where the institutional rates are determined by both clinical and surveillance cultures. The objectives of the study were to analyze the effect of changes in surveillance culture media on the rates and microbiological characteristics of CPE in a multicenter study. The rates were compared during 2 years in and between four centers. Two centers (Tel-Aviv and Beilinson) had changed their surveillance media to CHROMagar™ mSuperCARBA™ after 1 year, and two centers (Rambam and Hillel-Yaffe) had continued to use CHROMagar KPC. There was an increase in the rates of surveillance CPE in Tel-Aviv and Beilinson following the change in media, whereas the rates remained the same or declined in Rambam and Hillel-Yaffe, respectively. The rates of clinical CPE remained unchanged in Rambam and Hillel-Yaffe, declined in Tel-Aviv, and increased in Beilinson but to a lesser extent compared with the increase in surveillance CPE. The relative composition of the CPE mechanisms and species changed in Tel-Aviv, with an increase in non-Klebsiella pneumoniae species and in carbapenemase other than KPC. Our study shows that changes in surveillance media may contribute to significant changes in the rate of surveillance CPE that may be irrespective of actual epidemiological changes. Therefore, determination of institutional burden of CPE and the assessment of intervention results should be based primarily on the rate of clinical CPE rather than surveillance culture reports.

中文翻译：

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产碳青霉烯酶肠杆菌的机构负担：监测培养方法变化的影响。

旨在遏制产碳青霉烯酶肠杆菌 (CPE) 传播的以色列干预计划的一个重要部分是建立国家监测系统，其中机构比率由临床和监测文化决定。该研究的目的是在一项多中心研究中分析监测培养基的变化对 CPE 发生率和微生物特征的影响。在 2 年内和四个中心之间比较了这些比率。一年后，两个中心（特拉维夫和贝林森）已将其监测媒体更换为 CHROMagar™ mSuperCARBA™，两个中心（Rambam 和 Hillel-Yaffe）继续使用 CHROMagar KPC。随着媒体的变化，特拉维夫和贝林森的监视 CPE 率有所增加，而 Rambam 和 Hillel-Yaffe 的利率分别保持不变或下降。Rambam 和 Hillel-Yaffe 的临床 CPE 发生率保持不变，特拉维夫有所下降，Beilinson 有所增加，但与监测 CPE 的增加相比幅度较小。特拉维夫的 CPE 机制和物种的相对组成发生了变化，非肺炎克雷伯菌种和除 KPC 以外的碳青霉烯酶。我们的研究表明，监控媒体的变化可能会导致监控 CPE 发生率的显着变化，这可能与实际的流行病学变化无关。因此，CPE 机构负担的确定和干预结果的评估应主要基于临床 CPE 的发生率，而不是监测文化报告。