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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2015.1
- 수록면
- 167 - 174 (8page)
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Background: The rapid and accurate detection of carbapenemase-producing Enterobacteriaceae (CPE) in clinical microbiology laboratories is essential for the treatment and control of infections caused by these microorganisms. This study was performed to evaluate the ability of the VITEK AST-N202 card to detect CPE isolates.
Materials and Methods: A total of 43 (Klebsiella pneumoniae, n = 37; Escherichia coli, n = 3; and Enterobacter cloacae, n = 3) CPE isolates and 79 carbapenemase-non-producing Enterobacteriaceae (CNE) isolates were included in this study. The CPE isolates harbored KPC-2 (n = 11), KPC-3 (n = 20), GES-5 (n = 5), VIM-2 (n = 2), IMP-1 (n = 1), NDM-1 (n = 2), or OXA-232 (n = 2). Of the 79 CNE isolates, eight K. pneumoniae isolates were resistant to ertapenem, imipenem, and meropenem, while the remaining 71 isolates were susceptible to the carbapenems. Antimicrobial susceptibilities were tested using the VITEK AST-N202 card, and the results were interpreted as positive when the isolates showed resistant or intermediate results. Modified-Hodge tests (MHTs) were performed using ertapenem or meropenem disks for the screening of carbapenemase production. Polymerase chain reaction (PCR) and direct sequencing were used to identify β-lactamase genes.
Results: Sensitivity of MHT with ertapenem and meropenem disks for the detection of carbapenemase was 81.4% (35/43) and 81.4% (35/43), respectively, and a combination with both antibiotic disks increased the sensitivity to 88.4% (38/43). Specificity of the MHT was 100% (79/79) for the CNE isolates. Sensitivity of ertapenem, imipenem, and meropenem as assessed by the VITEK AST-N202 card was 100% (43/43), 93% (40/43), and 95.3% (41/43), respectively. Specificity (89.8%, 71/79) of the test with each carbapenem was improved to 100% (71/71) when eight carbapenem-resistant CNE isolates were excluded from the testing.
Conclusion: The VITEK AST-N202 card showed high sensitivity for the detection of carbapenemases in Enterobacteriaceae strains. PCR and sequencing experiments for the detection of carbapenemases are recommended when clinical Enterobacteriaceae isolates show non-susceptibility to carbapenems.
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참고문헌 (26)
참고문헌 신청
Lee Y / 2012 / Molecualr mechanisms of carbapenem resistance in Enterobacter cloacae clinical isolates from Korea and clinical outcome / Ann Clin Lab Sci 42:281~286
Kim MN / 2012 / Nosocomial clustering of NDM-1-producing Klebsiella pneumoniae sequence type 340 strains in four patients at a South Korean tertiary care hospital / J Clin Microbiol 50:1433~1436
Jeong SH / 2015 / Clonal and horizontal spread of the blaOXA-232 gene among Enterobacteriaceae in a Korean hospital / Diagn Microbiol Infect Dis 82:70~72
Yoo JS / 2013 / Nosocomial transmission of NDM-1-producing Escherichia coli ST101 in a Korean Hospital. / J Antimicrob Chemother 68:2170~2172
Bae IK / 2011 / Interspecies dissemination of the bla gene encoding PER-1 extended-spectrum β-lactamase / Antimicrob Agents Chemother 55 : 1305 ~ 1307
Kim MN / 2012 / Nosocomial clustering of NDM-1-producing Klebsiella pneumoniae sequence type 340 strains in four patients at a South Korean tertiary care hospital / J Clin Microbiol 50:1433~1436
Jeong SH / 2015 / Clonal and horizontal spread of the blaOXA-232 gene among Enterobacteriaceae in a Korean hospital / Diagn Microbiol Infect Dis 82:70~72
Yoo JS / 2013 / Nosocomial transmission of NDM-1-producing Escherichia coli ST101 in a Korean Hospital. / J Antimicrob Chemother 68:2170~2172
Bae IK / 2011 / Interspecies dissemination of the bla gene encoding PER-1 extended-spectrum β-lactamase / Antimicrob Agents Chemother 55 : 1305 ~ 1307
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