Comparative evaluation of in-house Carba NP test with other phenotypic tests for rapid detection of carbapenem-resistant Enterobacteriaceae.
CHROMagar
Carba NP test
carbapenem-resistant Enterobacteriaceae
modified Hodge test
Journal
Journal of clinical laboratory analysis
ISSN: 1098-2825
Titre abrégé: J Clin Lab Anal
Pays: United States
ID NLM: 8801384
Informations de publication
Date de publication:
Jan 2019
Jan 2019
Historique:
received:
08
05
2018
accepted:
28
07
2018
pubmed:
22
8
2018
medline:
16
2
2019
entrez:
22
8
2018
Statut:
ppublish
Résumé
The prevalence of carbapenem-resistant Enterobacteriaceae (CRE) is alarming worldwide causing serious infections. Rapid and accurate identification of CRE is crucial to reduce the mortality and morbidity. In this study, we tried to develop an in-house Carba NP test for detection of CRE and evaluate its performance with others. A prospective study was conducted with 40 nonrepeating Enterobacteriaceae isolates over a period of 3 months. All the isolates were screened for carbapenem resistance as per CLSI 2016 guidelines followed by PCR for blaNDM-1, blaOXA-48, blaKPC, blaVIM, and blaIMP genes. All the isolates were subjected to five phenotypic tests, that is, in-house Carba NP (iCarba NP), commercial Carba NP (cCarba NP), Blue-Carba, modified Hodge test (MHT), and CHROMagar. Among the 40 isolates, 87.5% were identified as Escherichia coli, 7.5% were Klebsiella pneumoniae, 2.5% were Enterobacter cloacae, and 2.5% were Citrobacter freundii. Thirty-three of 40 (82.5%) isolates were found to harbor one or more resistant genes. Considering PCR to be the gold standard test, sensitivity of the phenotypic methods for CRE detection ranged from 63.6% (MHT) to 96.9% (CHROMagar). Both cCarba NP and iCarba NP observed to have highest specificity. The performance of iCarba NP was found comparable with cCarba NP by kappa score 1 and found approximately 10 times less expensive than cCarba NP. CHROMagar was observed most sensitive assay for detection of CRE followed by both Carba NP tests. iCarba NP was proved cheaper and equally good as cCarba NP for detection of CRE.
Sections du résumé
BACKGROUND
BACKGROUND
The prevalence of carbapenem-resistant Enterobacteriaceae (CRE) is alarming worldwide causing serious infections. Rapid and accurate identification of CRE is crucial to reduce the mortality and morbidity. In this study, we tried to develop an in-house Carba NP test for detection of CRE and evaluate its performance with others.
METHODS
METHODS
A prospective study was conducted with 40 nonrepeating Enterobacteriaceae isolates over a period of 3 months. All the isolates were screened for carbapenem resistance as per CLSI 2016 guidelines followed by PCR for blaNDM-1, blaOXA-48, blaKPC, blaVIM, and blaIMP genes. All the isolates were subjected to five phenotypic tests, that is, in-house Carba NP (iCarba NP), commercial Carba NP (cCarba NP), Blue-Carba, modified Hodge test (MHT), and CHROMagar.
RESULTS
RESULTS
Among the 40 isolates, 87.5% were identified as Escherichia coli, 7.5% were Klebsiella pneumoniae, 2.5% were Enterobacter cloacae, and 2.5% were Citrobacter freundii. Thirty-three of 40 (82.5%) isolates were found to harbor one or more resistant genes. Considering PCR to be the gold standard test, sensitivity of the phenotypic methods for CRE detection ranged from 63.6% (MHT) to 96.9% (CHROMagar). Both cCarba NP and iCarba NP observed to have highest specificity. The performance of iCarba NP was found comparable with cCarba NP by kappa score 1 and found approximately 10 times less expensive than cCarba NP.
CONCLUSION
CONCLUSIONS
CHROMagar was observed most sensitive assay for detection of CRE followed by both Carba NP tests. iCarba NP was proved cheaper and equally good as cCarba NP for detection of CRE.
Identifiants
pubmed: 30129058
doi: 10.1002/jcla.22652
pmc: PMC6430338
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e22652Informations de copyright
© 2018 Wiley Periodicals, Inc.
Références
J Clin Microbiol. 2016 Feb;54(2):464-6
pubmed: 26607979
J Clin Lab Anal. 2019 Jan;33(1):e22652
pubmed: 30129058
J Clin Microbiol. 2013 Dec;51(12):4281-3
pubmed: 24108615
J Clin Microbiol. 2015 Oct;53(10):3359-62
pubmed: 26224841
Emerg Infect Dis. 2012 Sep;18(9):1503-7
pubmed: 22932472
Antimicrob Agents Chemother. 2014;58(2):1269
pubmed: 24470491
J Infect Chemother. 2017 Jan;23(1):1-11
pubmed: 27769646
Antimicrob Agents Chemother. 2013 Sep;57(9):4578-80
pubmed: 23817380
J Microbiol Methods. 2015 Jan;108:45-8
pubmed: 25451461
Clin Microbiol Infect. 2014 Apr;20(4):340-4
pubmed: 23889766
J Clin Microbiol. 2012 Feb;50(2):477-9
pubmed: 22116154
Lancet Infect Dis. 2010 Sep;10(9):597-602
pubmed: 20705517
J Clin Microbiol. 2008 Sep;46(9):3110-1
pubmed: 18632915
J Clin Microbiol. 2012 Dec;50(12):3877-80
pubmed: 22993175
Clin Microbiol Rev. 2016 Jan;29(1):1-27
pubmed: 26511484
Antimicrob Agents Chemother. 2014;58(2):1270
pubmed: 24470492
Expert Rev Anti Infect Ther. 2016 Aug;14(8):705-17
pubmed: 27348447
J Clin Microbiol. 2017 Dec;55(12):3437-3443
pubmed: 28978681
Mikrobiyol Bul. 2016 Jan;50(1):1-10
pubmed: 27058324
J Clin Microbiol. 2013 Sep;51(9):3097-101
pubmed: 23824767
J Lab Physicians. 2014 Jul;6(2):69-75
pubmed: 25328329
J Clin Microbiol. 2017 Apr;55(4):1046-1055
pubmed: 28077701
Clin Microbiol Infect. 2014 Sep;20(9):821-30
pubmed: 24930781
Antimicrob Agents Chemother. 2015 Dec;59(12):7870-2
pubmed: 26416868