Τίτλος:
Comparative evaluation of a prototype chromogenic medium (ChromID CARBA) for detecting carbapenemase-producing Enterobacteriaceae in surveillance rectal swabs
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Carbapenemase-producing Enterobacteriaceae (CPE) are an increasing problem worldwide, and rectal swab surveillance is recommended as a component of infection control programs. The performance of a prototype chromogenic medium (chromID CARBA) was evaluated and compared with media tested by four other screening methods: (i) overnight selective enrichment in 5 ml tryptic soy broth with a 10-μg ertapenem disk followed by plating onto MacConkey agar (CDC-TS), (ii) short selective enrichment in 9 ml brain heart infusion broth with a 10-μg ertapenem disk followed by plating onto chromID ESBL medium (ESBL-BH), (iii) direct plating onto chromID ESBL, and (iv) direct plating onto MacConkey agar supplemented with meropenem (1 μg/ml) (MCM). The screening methods were applied to detect CPE in 200 rectal swab specimens taken from different hospitalized patients. Identification and antimicrobial susceptibility were performed by the Vitek 2 system. Carbapenem MICs were checked by Etest. Carbapenemase production was confirmed using the modified Hodge test, combined-disk tests, and PCR assays. In total, 133 presumptive CPE strains were detected. Phenotypic and genotypic assays confirmed 92 strains to be CPE (56 KPC-positive Klebsiella pneumoniae, 29 VIM-positive K. pneumoniae, and 7 KPC-positive Enterobacter aerogenes strains) recovered from 73 patients, while the remaining 41 strains were confirmed to be CPE negative (19 ESBL producers and 22 nonfermenters). chromID CARBA, ESBL-BH, and chromID ESBL exhibited the highest sensitivity (92.4%), followed by CDC-TS and MCM (89.1%) (P = 0.631). The specificity was greater for chromID CARBA (96.9%) and ESBL-BH (93.2%) than for CDC-TS (86.4%), MCM (85.2%), and chromID ESBL (84.7%) (P = 0.014). In conclusion, chromID CARBA was found to be a rapid and accurate culture screening method for active CPE surveillance. Copyright © 2012, American Society for Microbiology. All Rights Reserved.
Συγγραφείς:
Vrioni, G.
Daniil, I.
Voulgari, E.
Ranellou, K.
Koumaki, V.
Ghirardi, S.
Kimouli, M.
Zambardi, G.
Tsakris, A.
Περιοδικό:
Journal of Clinical Microbiology
Λέξεις-κλειδιά:
carbapenem; carbapenemase; chromogenic substrate; ertapenem; meropenem, antibiotic sensitivity; article; bacterial strain; bacterium detection; carbapenemase producing Enterobacteriaceae; comparative study; controlled study; Enterobacter aerogenes; Enterobacteriaceae; Enterobacteriaceae infection; enzyme synthesis; genotype; health survey; human; human tissue; intermethod comparison; Klebsiella pneumoniae; major clinical study; minimum inhibitory concentration; nonhuman; phenotype; polymerase chain reaction; priority journal; screening test; sensitivity and specificity; species differentiation, Bacterial Proteins; Bacteriological Techniques; beta-Lactamases; Carbapenems; Culture Media; Enterobacter aerogenes; Enterobacteriaceae; Enterobacteriaceae Infections; Genotype; Humans; Klebsiella pneumoniae; Mass Screening; Microbial Sensitivity Tests; Phenotype; Polymerase Chain Reaction; Rectum; Sensitivity and Specificity, Enterobacter aerogenes; Enterobacteriaceae; Klebsiella pneumoniae
DOI:
10.1128/JCM.06848-11
