While screening the rectal site and urine may be appropriate for detection of carbapenemase-producing Enterobacterales, respiratory samples, throat and wound swabs may increase the sensitivity of screening protocols when aiming to detect colonization with carbapenemase-producing non-fermenting bacteria. Vock, et al. (2025) say the results of their study support the need for tailoring screening recommendations according to the bacterial species targeted.

As the authors explain, "Active surveillance by screening high-risk patients for carbapenemases-producing bacteria (CPB) is a crucial part of infection prevention and control measures (I&PC) as recommended by international guidelines such as the ones published by the World Health Organization. Given the natural intestinal colonization with Enterobacterales, patients colonized with carbapenemase-producing Enterobacterales (CPE) can be identified by rectal swabs in a majority of the cases. In contrast, knowledge regarding the optimal screening sites for detection of carbapenemase-producing non-fermenting bacteria (CPNF), such as Acinetobacter baumannii complex or Pseudomonas species, is limited. Consequently, recommendations for active surveillance cultures remain inconclusive, leading to different screening practices within healthcare institutions. Enhancing comprehension of body sites most likely colonized with CPE and CPNF may help tailoring species-specific screening strategies, facilitating early detection of patients at risk for CPB-colonization and possibly minimizing costs for screening of body sites unlikely to add further diagnostic value."

To address this gap, the researchers evaluated different body sites for the detection of CPB by comparing the proportions of positive sites between patients colonized with CPE and CPNF, to provide insights for the refinement of screening strategies.

Reference: Vock I, et al. Screening sites for detection of carbapenemase-producers– a retrospective cohort study. Antimicrobial Resistance & Infection Control. Vol. 13, article number 157 (2024).