Test evaluation and strategy proposal to detect and to characterize carbapenemase-producing gram negative bacilli
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Date
2017
Journal Title
Journal ISSN
Volume Title
Publisher
SOC CHILENA INFECTOLOGIA
Abstract
Introduction: The detection of carbapenemase-producing gram negative bacilli is complicated, because there are available multiple options of test. The confirmation of the enzyme by molecular characterization is not available in all laboratories in our country. Objective: To propose a fast, efficient and simple strategy to detect and confirm CPB. Materials and Methods: 39 CPB isolates and 8 non-producing were used to evaluate the phenotypic test Carba NP, CarbAcineto NP and Blue-Carba, validating the test Xpert (R) Carba-R, to be used directly with bacterial colonies with conventional PCR. Results: The sensitivity of Carba NP, CarbAcineto NP and Blue-Carba was 79,5; 87,2 y 84,6%, respectively; and specificity was 79.5; 87.2 and 84.6%, respectively. The limit of detection of Xpert (R) Carba-R was different for each carbapenemasa: 40.8 ufc/reaction to KPC and NDM and 30.6 ufc/reaction to VIM. Discussion: On isolates with decreased susceptibility to carbapenems we propose to use as screening the test CarbAcineto NP, follow by Xpert (R) Carba-R to characterize the carbapenemase and adopt specific infection control measures.
Description
Keywords
Carbapenemases, gram negative bacilli, Xpert (R) Carba-R, Carba NP, BETA-LACTAMASE, KLEBSIELLA-PNEUMONIAE, RAPID DETECTION, ENTEROBACTERIACEAE, RESISTANCE, ALGORITHM, PROGRAM, CHILE, ASSAY