A Pilot Study on Carbapenemase Detection: Do We See the Same Level of Agreement as with the CLSI Observations

Journal of Clinical and Diagnostic Research

卷:10

Balaji Veeraraghavan¹  Shalini Anandan²  Rani Diana Sahni²  Archa Sharma³  Priya Gunasekaran⁴  Agila Kumari Pragasam⁴  Radha Gopi⁴  Noorjahan Hadibasha⁴ 

[1] Professor & Head, Department of Clinical Microbiology, Christian Medical College, Vellore, India.;

[2] Professor, Department of Clinical Microbiology, Christian Medical College, Vellore, India.;

[3] Registrar, Department of Clinical Microbiology, Christian Medical College, Vellore, India.;

[4] Research Associate, Department of Clinical Microbiology, Christian Medical College, Vellore, India.;

关键词: carbanp;    mht;    metallo beta lactamases;    class d oxacillinases;   

DOI  :  10.7860/JCDR/2016/16417.8152

来源: DOAJ

【 摘 要 】

Introduction: Rapid identification of carbapenemase producingorganisms is of great importance for timely detection, treatmentand implementation of control measures to prevent thespread. The Modified Hodge Test (MHT) and Carba NP test isrecommended by CLSI for the detection of carbapenemases inEnterobacteriaceae. However, MHT may give false positive resultsor fail to detect metallo β-lactamases (MBLs). In the US, MHT isthe most widely used test for detection of carbapenemases andhas been found to have a sensitivity and specificity of >90% forblaKPC producers. However, in India, the prevalence of blaNDM ishigher than blaKPC producers.Aim: To evaluate the usefulness of CarbaNP in an Indian setting.Materials and Methods: A total of 260 isolates of carbapenemresistant E.coli (n=57), Klebsiella spp. (n=85), Pseudomonasaeruginosa (n=60), and Acinetobacter baumannii (58) isolatedfrom clinical specimens between 2012-2014 at the ChristianMedical College, Vellore were included in the study. All thecarbapenem resistant isolates were subjected to CarbaNP, MHTand multiplex PCR for detection of carbapenemase genes.Results: CarbaNP was found to be positive in 88% (n=50/57),81% (n=69/51), 38% (n=23/60) and 81% (n=47/58) for E.coli,Klebsiella spp., P. aeruginosa, and A. baumannii respectively.While in MHT it showed, 89% (n=51/57) and 81 % (n=69/85)for E.coli and Klebsiella spp. respectively. In P.aeruginosa,synergy testing of imipenem plus cloxacillin showed that, 65%of CarbaNP negatives were ampC producers. Overall, thesensitivity and specificity of CarbaNP was found to be 94% and100 for blaNDM; 77% and 100 % for blaOXA-48 like producers and81% and 100% for CarbAcinetoNP respectively.Conclusion: This observation was more than what was reportedin CLSI guidelines. Therefore, it is advisable to evaluate an assayfor better laboratory diagnosis at respective regions.

【 授权许可】

Unknown