지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2015.1
- 수록면
- 298 - 305 (8page)
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초록· 키워드
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Background: The modified Hodge test (MHT) was designed to detect carbapenemase-producing Enterobacteriaceae (CPE). This study evaluated variables to improve the performance of MHT.
Methods: Carbapenem-resistant Enterobacteriaceae isolated from November 2010 to March 2013 at the Asan Medical Center, were evaluated, including 33 metallo-β-lactamase (MBL) producers and 103 non-CPEs. MHT was performed by using two carbapenem disks (ertapenem and meropenem; Becton Dickinson, USA), three media (Mueller-Hinton agar (MHA), MacConkey agar (MAC), and zinc-enriched MHA), and two inoculums (0.5-McFarland [McF] suspension and a 10-fold dilution of it.) PCR was performed to detect β-lactamase genes of the MBL, AmpC, and CTX-M types.
Results: The sensitivity of MHT for detecting New Delhi metallo-β-lactamase (NDM) producers was highest using ertapenem and 0.5-McF, 52.0% on MHA and 68.0% on MAC, respectively. NDM-producing Klebsiella pneumoniae (NDMKP) were detected with higher sensitivity on MAC (78.6%) vs. MHA (28.6%) (P=0.016), but VIM-producing Enterobacter, Citrobacter, and Serratia were detected with higher sensitivity on MHA (78.5%) vs. MAC (14.3%) (P=0.004). MBL producers were consistently identified with lower sensitivity using meropenem vs. ertapenem, 39.4% vs. 60.6% (P=0.0156), respectively. The effects of zinc and inoculum size were insignificant. Enterobacter aerogenes producing unspecified AmpC frequently demonstrated false positives, 66.7% with ertapenem and 22.2% with meropenem.
Conclusions: The MHT should be adjusted for the local distribution of species and the carbapenemase type of MBL producers. MAC and ertapenem are preferable for assessing NDMKP, but MHA is better for VIM. Laboratory physicians should be aware of the limited sensitivity of MHT and its relatively high false-positive rate.
목차
등록된 정보가 없습니다.
참고문헌 (21)
참고문헌 신청
Birgy A / 2012 / Phenotypic screening of carbapenemases and associated β-lactamases in carbape nem-resistant Enterobacteriaceae / J Clin Microbiol 50 : 1295 ~ 1302
Castanheira M / 2011 / Early dissemination of NDM-1- and OXA-181-producing Enterobacteriaceae in Indian hospitals: report from the SENTRY Antimicrobial Surveillance Program,
Cohen Stuart J / 2010 / Guideline for phenotypic screening and confirmation of carbapenemases in Enterobacteriaceae / Int J Antimicrob Agents 36 : 205 ~ 210
Doyle D / 2012 / Laboratory detection of Enterobacteriaceae that produce carbapenemases / J Clin Microbiol 50 : 3877 ~ 3880
Ellington MJ / 2007 / Multiplex PCR for rapid detection of genes encoding acquired metallo-beta-lactamases / J Antimicrob Chemother 59 : 321 ~ 322
Castanheira M / 2011 / Early dissemination of NDM-1- and OXA-181-producing Enterobacteriaceae in Indian hospitals: report from the SENTRY Antimicrobial Surveillance Program,
Cohen Stuart J / 2010 / Guideline for phenotypic screening and confirmation of carbapenemases in Enterobacteriaceae / Int J Antimicrob Agents 36 : 205 ~ 210
Doyle D / 2012 / Laboratory detection of Enterobacteriaceae that produce carbapenemases / J Clin Microbiol 50 : 3877 ~ 3880
Ellington MJ / 2007 / Multiplex PCR for rapid detection of genes encoding acquired metallo-beta-lactamases / J Antimicrob Chemother 59 : 321 ~ 322
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