Carbapenem Inactivation Method: Accurate Detection and Easy Interpretation of Carbapenemase Production in Enterobacteriaceae and Pseudomonas spp.
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: We evaluated the carbapenem inactivation method (CIM) compared with the modified Hodge test (MHT) for the detection of carbapenemase- producing Gram-negative bacilli. Methods: A total of 61 isolates of carbapenemaseproducing Enterobacteriaceae (CPE: 14 KPC, 7 GES- 5, 8 NDM-1, 9 VIM-2, 9 IMP-1, and 14 OXA-48-like), 34 isolates of metallo-β-lactamase (MBL)-producing Pseudomonas spp. (14 VIM-2 and 20 IMP-6), and 70 carbapenem-nonsusceptible carbapenemase-negative isolates were included. The CIM and MHT were performed for all of the isolates. To perform the CIM, a meropenem disk was incubated with a suspension of the isolate to be tested and then on Mueller-Hinton agar with the Escherichia coli ATCC 29522 strains. The absence of an inhibition zone indicates presence of a carbapenemase. The presence of a clearing zone indicates lack of a carbapenemase. Results: The total sensitivity and specificity of CIM (96% sensitivity and 100% specificity) in carbapenemnonsusceptible Enterobacteriaceae and Pseudomonas spp. were better than those of the MHT (77% sensitivity and 94% specificity). The interpretation of CIM results was easy, with no or ＜20 mm inhibition zones indicating positivity and ＞20 mm inhibition zones indicating negative carbapenemase activity. Conclusion: The CIM had excellent sensitivity and specificity for detection of CPE and MBL-producing Pseudomonas spp., and a positive result was easily determined, unlike the MHT.
Abstract
Background: We evaluated the carbapenem inactivation method (CIM) compared with the modified Hodge test (MHT) for the detection of carbapenemase- producing Gram-negative bacilli. Methods: A total of 61 isolates of carbapenemaseproducing Enterobacteriaceae (CPE: 14 KPC, 7 GES- 5, 8 NDM-1, 9 VIM-2, 9 IMP-1, and 14 OXA-48-like), 34 isolates of metallo-β-lactamase (MBL)-producing Pseudomonas spp. (14 VIM-2 and 20 IMP-6), and 70 carbapenem-nonsusceptible carbapenemase-negative isolates were included. The CIM and MHT were performed for all of the isolates. To perform the CIM, a meropenem disk was incubated with a suspension of the isolate to be tested and then on Mueller-Hinton agar with the Escherichia coli ATCC 29522 strains. The absence of an inhibition zone indicates presence of a carbapenemase. The presence of a clearing zone indicates lack of a carbapenemase. Results: The total sensitivity and specificity of CIM (96% sensitivity and 100% specificity) in carbapenemnonsusceptible Enterobacteriaceae and Pseudomonas spp. were better than those of the MHT (77% sensitivity and 94% specificity). The interpretation of CIM results was easy, with no or ＜20 mm inhibition zones indicating positivity and ＞20 mm inhibition zones indicating negative carbapenemase activity. Conclusion: The CIM had excellent sensitivity and specificity for detection of CPE and MBL-producing Pseudomonas spp., and a positive result was easily determined, unlike the MHT.
참고문헌 (19)
- Patel JB, "Carbapenemases in Enterobacteriaceae: activity, epidemiology, and laboratory detection", Clin Microbiol Newsletter, 31, pp.55~62 (2009)
- Girlich D, "Value of the modified Hodge test for detection of emerging carbapenemases in Enterobacteriaceae", J Clin Microbiol, 50, pp.477~479 (2012)
- Jeong SH, "Broth microdilution methods using B-lactamase inhibitors for the identification of Klebsiella pneumoniae carbapenemases and metallo-β-lactamases in Gram-negative bacilli", Ann Clin Lab Sci, 44, pp.49~55 (2014)
- Papagiannitsis CC, "Matrix-assisted laser desorption ionization-time of flight mass spectrometry meropenem hydrolysis assay with NH4HCO3, a reliable tool for direct detection of carbapenemase activity", J Clin Microbiol, 53, pp.1731~1735 (2015)
- CLSI, "Performance standards for antimicrobial susceptibility testing. CLSI document M100-S23", Clinical and Laboratory Standards Institute, ~ (2013)
- Anderson KF, "Evaluation of methods to identify the Klebsiella pneumoniae carbapenemase in Enterobacteriaceae", J Clin Microbiol, 45, pp.2723~2725 (2007)
- Pasteran F, "Sensitive screening tests for suspected class A carbapenemase production in species of Enterobacteriaceae", J Clin Microbiol, 47, pp.1631~1639 (2009)
- Pasteran F, "Controlling false-positive results obtained with the Hodge and Masuda assays for detection of class a carbapenemase in species of Enterobacteriaceae by incorporating boronic acid", J Clin Microbiol, 48, pp.1323~1332 (2010)
- Carvalhaes CG, "Cloverleaf test (modified Hodge test) for detecting carbapenemase production in Klebsiella pneumoniae: be aware of false positive results", J Antimicrob Chemother, 65, pp.249~251 (2010)
- Doumith M, "Molecular mechanisms disrupting porin expression in ertapenem-resistant Klebsiella and Enterobacter spp. clinical isolates from the UK", J Antimicrob Chemother, 63, pp.659~667 (2009)
- Hirsch EB, "Detection and treatment options for Klebsiella pneumoniae carbapenemases (KPCs): an emerging cause of multidrug-resistant infection", J Antimicrob Chemother, 65, pp.1119~1125 (2010)
- van der Zwaluw K, "The carbapenem inactivation method (CIM), a simple and low-cost alternative for the Carba NP test to assess phenotypic carbapenemase activity in gram-negative rods", PLoS One, 10, pp.e0123690~ (2015)
- Jeong S, "Evaluation of peptide nucleic acid-mediated multiplex real-time PCR kits for rapid detection of carbapenemase genes in gram-negative clinical isolates", J Microbiol Methods, 113, pp.4~9 (2015)
- 송원근, "Combined Use of the Modified Hodge Test and Carbapenemase Inhibition Test for Detection of Carbapenemase-Producing Enterobacteriaceae and Metallo-β-Lactamase-Producing Pseudomonas spp.", Annals of Laboratory Medicine, 35(2), pp.212~219 (2015), 대한진단검사의학회
- Tijet N, "Detection of carbapenemase activity in Enterobacteriaceae: comparison of the carbapenem inactivation method versus the Carba NP test", J Antimicrob Chemother, 71, pp.274~276 (2016)
- Yamada K, "Comparison of the modified-hodge test, Carba NP test, and carbapenem inactivation method as screening methods for carbapenemaseproducing Enterobacteriaceae", J Microbiol Methods, 126, pp.48~51 (2016)
- Nordmann P, "Rapid detection of carbapenemaseproducing Enterobacteriaceae", Emerg Infect Dis, 18, pp.1503~1507 (2012)
- Dortet L, "Rapid detection of carbapenemaseproducing Pseudomonas spp", J Clin Microbiol, 50, pp.3773~3776 (2012)
- Tijet N, "Evaluation of the Carba NP test for rapid detection of carbapenemaseproducing Enterobacteriaceae and Pseudomonas aeruginosa", Antimicrob Agents Chemother, 57, pp.4578~4580 (2013)