University of Limerick
OConnor_2016_optimised.pdf (308.32 kB)

An optimised work-flow to reduce time-to-detection of carbapenemase-producing Enterobacteriaceae (CPE) using direct testing from rectal swabs

Download (308.32 kB)
journal contribution
posted on 2023-02-23, 15:57 authored by Ciara O'Connor, MIRANDA KIERNANMIRANDA KIERNAN, Cathriona Finnegan, Maureen O'Hara, Lorraine Power, Nuala H. O'Connell, COLUM DUNNECOLUM DUNNE
Rapid detection of patients with carbapenem-producing Enterobacteriaceae (CPE) is essential for the prevention of nosocomial cross-transmission, allocation of isolation facilities and to protect patient safety. Here, we aimed to design a new laboratory work-flow, utilising existing laboratory resources, in order to reduce time-to-diagnosis of CPE. A review of the current CPE testing processes and of the literature was performed to identify a real-time commercial polymerase chain reaction (PCR) assay that could facilitate batch testing of CPE clinical specimens, with adequate CPE gene coverage. Stool specimens (210) were collected; CPE-positive inpatients (n=10) and anonymised community stool specimens (n=200). Rectal swabs (eSwab™) were inoculated from collected stool specimens and a manual DNA extraction method (QIAamp® DNA Stool Mini Kit) was employed. Extracted DNA was then processed on the Check-Direct CPE® assay. The three step process of making the eSwab™, extracting DNA manually and running the Check-Direct CPE® assay, took <5 minutes, 1 hour 30 minutes and 1 hour 50 minutes, respectively. It was time efficient with a result available in under 4 hours, comparing favourably with the existing method of CPE screening; average time-to-diagnosis of 48/72 hours. Utilising this CPE work-flow would allow a ‘same-day’ result. Antimicrobial susceptibility testing results, as is current practice, would remain a ‘next-day’ result. In conclusion, the Check-Direct CPE® assay was easily integrated into a local laboratory work-flow and could facilitate a large volume of CPE screening specimens in a single batch, making it cost-effective and convenient for daily CPE testing.



Bioengineered; 8 (3), pp. 217-224


Taylor and Francis




This is an Author's Original Manuscript of an article whose final and definitive form, the Version of Record, has been published in Bioengineered, 2016 © copyright Taylor & Francis, available online at:



Also affiliated with

  • 4i - Centre for Interventions in Infection, Inflammation & Immunity

Department or School

  • School of Medicine

Usage metrics

    University of Limerick


    No categories selected


    Ref. manager