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Evaluation of Six Phenotypic Methods for the Detection of Carbapenemases in Gram-Negative Bacteria With Characterized Resistance Mechanisms
Annals of Laboratory Medicine ; : 305-312, 2017.
Article in English | WPRIM | ID: wpr-186612
ABSTRACT

BACKGROUND:

We compared the performance of the modified Hodge test (MHT), Triton Hodge test (THT), Carba NP test (CNPt), simplified Carba NP test (CNPt-direct), blue-Carba NP test (BCT), and carbapenem inactivation method (CIM) for rapid and accurate carbapenemase detection.

METHODS:

The methods were evaluated by using 256 gram-negative isolates, including 197 Enterobacteriaceae (79 Enterobacter spp., 74 Klebsiella spp., 33 Escherichia coli, 10 Citrobacter spp., and 1 Serratia marcescens), 51 Acinetobacter baumannii, and 8 Pseudomonas aeruginosa strains. The collection included 117 non-carbapenemase, 18 Klebsiella pneumoniae carbapenemases (KPC) producers, 46 New Delhi metallo-β-lactamases (NDM) producers, 11 imipenemases (IMP) producers, and 51 oxacillinases (OXA) producers, and 13 strains harboring two different carbapenemase genes.

RESULTS:

The specificity of the THT (91.5%) was significantly lower than other methods, each of which had 100% specificity (P0.999). Because of improved detection of NDM carriers, THT showed significantly higher sensitivity than the MHT (84.9% vs 75.5%, P<0.001). However, poor performances in detecting OXA still influenced the sensitivities of the CNPt (66.2%) and BCT (82.0%), as well as the MHT and THT.

CONCLUSIONS:

CNPt-direct and CIM demonstrated the best performance for the efficient detection of carbapenemase among the six evaluated methods. Except the MHT and THT, the detection of carbapenemase-producing Enterobacteriaceae by all the other methods was acceptable, when the OXA-type carbapenemase was not prevalent.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Pseudomonas aeruginosa / Serratia / Citrobacter / Sensitivity and Specificity / Neptune / Acinetobacter baumannii / Enterobacter / Enterobacteriaceae / Escherichia coli / Gram-Negative Bacteria Type of study: Diagnostic study Language: English Journal: Annals of Laboratory Medicine Year: 2017 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Pseudomonas aeruginosa / Serratia / Citrobacter / Sensitivity and Specificity / Neptune / Acinetobacter baumannii / Enterobacter / Enterobacteriaceae / Escherichia coli / Gram-Negative Bacteria Type of study: Diagnostic study Language: English Journal: Annals of Laboratory Medicine Year: 2017 Type: Article