Disk Carbapenemase Test for the Rapid Detection of KPC-, NDM-, and Other Metallo-β-Lactamase-Producing Gram-Negative Bacilli
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Background: Rapid detection of carbapenemase-producing gram-negative bacilli (GNB) is required for optimal treatment of infected patients. We developed and assessed a new disk carbapenemase test (DCT). Methods: Paper disks containing 0.3 mg of imipenem and bromothymol blue indicator were developed, and the performance of the DCT were evaluated by using 742 strains of GNB with or without carbapenemases. Results: The paper disks were simple to prepare, and the dried disks were stable at -20°C and at 4°C. The DCT detected 212 of 215 strains (98.6% sensitivity with 95% confidence interval [CI] 96.0-99.5%) of GNB with known class A (KPC and Sme) and class B (NDM, IMP, VIM, and SIM) carbapenemases within 60 min, but failed to detect GES-5 carbapenemase. The DCT also detected all two Escherichia coli isolates with OXA-48, but failed to detect GNB with OXA-232, and other OXA carbapenemases. The DCT showed 100% specificity (95% CI, 99.2-100%) in the test of 448 imipenem-nonsusceptible, but carbapenemase genes not tested, clinical isolates of GNB. Conclusions: The DCT is simple and can be easily performed, even in small laboratories, for the rapid detection of GNB with KPC, NDM and the majority of IMP, VIM, and SIM carbapenemases.
Abstract
Background: Rapid detection of carbapenemase-producing gram-negative bacilli (GNB) is required for optimal treatment of infected patients. We developed and assessed a new disk carbapenemase test (DCT). Methods: Paper disks containing 0.3 mg of imipenem and bromothymol blue indicator were developed, and the performance of the DCT were evaluated by using 742 strains of GNB with or without carbapenemases. Results: The paper disks were simple to prepare, and the dried disks were stable at -20°C and at 4°C. The DCT detected 212 of 215 strains (98.6% sensitivity with 95% confidence interval [CI] 96.0-99.5%) of GNB with known class A (KPC and Sme) and class B (NDM, IMP, VIM, and SIM) carbapenemases within 60 min, but failed to detect GES-5 carbapenemase. The DCT also detected all two Escherichia coli isolates with OXA-48, but failed to detect GNB with OXA-232, and other OXA carbapenemases. The DCT showed 100% specificity (95% CI, 99.2-100%) in the test of 448 imipenem-nonsusceptible, but carbapenemase genes not tested, clinical isolates of GNB. Conclusions: The DCT is simple and can be easily performed, even in small laboratories, for the rapid detection of GNB with KPC, NDM and the majority of IMP, VIM, and SIM carbapenemases.
참고문헌 (16)
- Lee K, "Modified Hodge test and EDTA-disk synergy tests to screen metallo-β-lactamase-producing strains of Pseudomonas and Acinetobacter species", Clin Microbiol Infect, 7, pp.88~91 (2001)
- Nordmann P, "Rapid detection of carbapenemase-producing Enterobacteriaceae", Emerg Infect Dis, 18, pp.1503~1507 (2012)
- Dortet L, "Rapid identification of carbapenemase types in Enterobacteriaceae and Pseudomonas spp. by using a biochemical test", Antimicrob Agents Chemother, 56, pp.6437~6440 (2012)
- Clinical and Laboratory Standards Institute, "Performance standards for antimicrobial susceptibility testing.Twenty-fifth Informational supplement, M100-S25", Clinical and Laboratory Standards Institute, ~ (2015)
- Pires J, "Blue-carba, an easy biochemical test for detection of diverse carbapenemase producers directly from bacterial cultures", J Clin Microbiol, 51, pp.4281~4283 (2013)
- Shiraki Y, "Escherichia coli producing CTX-M-2 β-lactamase in cattle", Japan. Emerg Infect Dis, 10, pp.69~75 (2004)
- Sang Sook Hong, "Multiplex PCR for Rapid Detection of Genes Encoding Class A Carbapenemases", Annals of Laboratory Medicine, 32(5), pp.359~361 (2012), 대한진단검사의학회
- Solé M, "First description of an Escherichia coli strain producing NDM-1 carbapenemase in Spain", Antimicrob Agents Chemother, 55, pp.4402~4404 (2011)
- Lee K, "Novel acquired metallo-β-lactamase gene, blaSIM-1, in a class 1 integron from Acinetobacter baumannii clinical isolates from Korea", Antimicrob Agents Chemother, 49, pp.4485~4491 (2005)
- Woodford N, "Multiplex PCR for genes encoding prevalent OXA carbapenemases in Acinetobacter spp", Int J Antimicrob Agents, 27, pp.351~353 (2006)
- Tam VH, "Prevalence, resistance mechanisms, and susceptibility of multidrug-resistant bloodstream isolates of Pseudomonas aeruginosa", Antimicrob Agents Chemother, 54, pp.1160~1164 (2010)
- Tijet, N, "Evaluation of the Carba NP test for rapid detection of carbapenemase-producing Enterobacteriaceae and Pseudomonas aeruginosa", Antimicrob Agents Chemother, 57, pp.4578~4580 (2013)
- Docquier JD, "On functional and structural heterogeneity of VIM-type metallo-β-lactamases", J Antimicrob Chemother, 51, pp.257~266 (2003)
- Potron A, "Genetic and biochemical characterisation of OXA-232, a carbapenem-hydrolysing class D β-lactamase from Enterobacteriaceae", Int J Antimicrob Agents, 41, pp.325~329 (2013)
- Walther-Rasmussen J, "OXA-type carbapenemases", J Antimicrob Chemother, 57, pp.373~383 (2006)
- Zhou Y, "Genetic characterization of ST195 and ST365 carbapenem-resistant Acinetobacter baumannii harboring blaOXA-23 in Guangzhou, China", Microb Drug Resist, 21, pp.386~390 (2015)