Screening for ESBL-Producing and Carbapenemase-Producing Enterobacteriales

From each participant, a rectal swab was collected and transported in liquid Cary-Blair medium (Fecal Transwab, MWE Co Bath Ltd., Corsham, United Kingdom) in a cool box and maintained at 4°C with icepack. Rectal swabs were inoculated into brain heart infusion (BHI) broth and incubated overnight at 37°C. Two drops (0.1 mL) from BHI broth were subcultured on CHROMID ESBL (BioMérieux, Marcy l'Etoile, France) for screening of ESBL-PE,^{19 (link)} and CHROMID CARBA SMART (BioMérieux) for combined screening for carbapenemase-producing Enterobacteriaceae (CPE) and OXA-48-producing Enterobacteriaceae. The plates were incubated at 37°C for 24 hours and bacterial growth interpreted according to manufacturer's instructions. Molecular characterized strains harboring different combinations of β-lactamases were used for quality control as previously described.^{14 (link)}Bacterial isolates were identified by MALDI-TOF MS using the Microflex LT instrument and MALDI Biotyper 3.1 software (Bruker Daltonics, Bremen, Germany).