1887

Abstract

Increasing numbers of clinical isolates of that produce carbapenemase are now being detected, with the most common carbapenemase found among in Japan being IMP-1-type metallo-β-lactamase. Clinical isolates of harbouring carbapenemases may be resistant to carbapenem antimicrobial agents, despite apparent susceptibility when tested according to Clinical and Laboratory Standards Institute criteria. We evaluated the prevalence of carbapenemase producers among isolates of at our hospital and assessed the performance of the modified Hodge test (MHT) for correctly identifying the phenotype. We studied 47 clinical isolates obtained between 2006 and 2010 for which the MIC of imipenem was 2 or 4 μg imipenem ml. Antibacterial susceptibility testing was done for cephalosporins and carbapenems, the MHT was performed with meropenem and detection of the genes encoding IMP-1, VIM-2, KPC-2 and NDM-1-type metallo-β-lactamases was performed by PCR. Twelve isolates showed a positive result in the MHT with meropenem and were classified as carbapenemase producers. Of these 12 isolates, seven carried the gene for IMP-1 type, but not for VIM-2, KPC-2 or NDM-1 types. None of the carbapenemase genes tested were detected in the other five isolates. All five isolates were showing high resistance to ceftazidime and aztreonam. False-positive results were inhibited when Mueller–Hinton agar supplemented with 200 mg cloxacillin ml was used for the MHT. Five of 12 MHT-positive isolates were shown to have no carbapenemase genes and these isolates were high AmpC producers. Adding cloxacillin when performing the MHT prevented such false-positive results. The MHT with cloxacillin can overcome most problems related to detection of carbapenemases.

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2015-07-01
2024-04-19
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References

  1. Bartolini A., Frasson I., Cavallaro A., Richter S.N., Palù G. 2014; Comparison of phenotypic methods for the detection of carbapenem non-susceptible Enterobacteriaceae. Gut Pathog.
    [Google Scholar]
  2. Carvalhaes C.G., Picão R.C., Nicoletti A.G., Xavier D.E., Gales A.C. 2010; Cloverleaf test (modified Hodge test) for detecting carbapenemase production in Klebsiella pneumoniae: be aware of false positive results. J Antimicrob Chemother 65:249–251 [View Article][PubMed]
    [Google Scholar]
  3. CLSI 2009 Performance Standards for Antimicrobial Susceptibility Testing 19th Informational Supplement M100–S19. Wayne, PA: Clinical Laboratory Standards Institute;
    [Google Scholar]
  4. CLSI 2012 Performance Standards for Antimicrobial Susceptibility Testing European Committee on Antimicrobial Susceptibility Testing Breakpoint tables for interpretation of MICs and zone diameters M100–S21 Wayne, PA: Clinical Laboratory Standards Institute;
    [Google Scholar]
  5. European Committee on Antimicrobial Susceptibility Testing Breakpoint tables for interpretation of MICs and zone diameters Version 5.0, valid from 2015-01-01.
  6. Galani I., Rekatsina P.D., Hatzaki D., Plachouras D., Souli M., Giamarellou H. 2008; Evaluation of different laboratory tests for the detection of metallo-beta-lactamase production in Enterobacteriaceae . J Antimicrob Chemother 61:548–553 [View Article][PubMed]
    [Google Scholar]
  7. Giske C.G., Gezelius L., Samuelsen Ø., Warner M., Sundsfjord A., Woodford N. 2011; A sensitive and specific phenotypic assay for detection of metallo-β-lactamases and KPC in Klebsiella pneumoniae with the use of meropenem disks supplemented with aminophenylboronic acid, dipicolinic acid and cloxacillin. Clin Microbiol Infect 17:552–556 [View Article][PubMed]
    [Google Scholar]
  8. Kawakami S., Ono Y., Yamamoto M., Matumura M., Okamoto R., Inoue M., Miyazawa Y. 2000; [Extended-spectrum β-lactamase (ESBL) produced by Escherichia coli Klebsiella pneumoniae isolated from Teikyo University Hospital–the second report]. Kansenshogaku Zasshi 74:24–29 [View Article] (in Japanese) [PubMed]
    [Google Scholar]
  9. Mathers A.J., Carroll J., Sifri C.D., Hazen K.C. 2013; Modified Hodge test versus indirect carbapenemase test: prospective evaluation of a phenotypic assay for detection of Klebsiella pneumoniae carbapenemase (KPC) in Enterobacteriaceae. J Clin Microbiol . 51:1291–1293 [View Article][PubMed]
    [Google Scholar]
  10. Moland E.S., Kim S.Y., Hong S.G., Thomson K.S. 2008; Newer beta-lactamases: clinical and laboratory implications, part II. Clin Microbiol Newsl 30:79–85 [View Article]
    [Google Scholar]
  11. Nordmann P., Girlich D., Poirel L. 2012; Detection of carbapenemase producers in Enterobacteriaceae by use of a novel screening medium. J Clin Microbiol 50:2761–2766 [View Article][PubMed]
    [Google Scholar]
  12. Oteo J., Miró E., Pérez-Vázquez M., Navarro F. 2014; Evolution of carbapenemase-producing Enterobacteriaceae at the global and national level: what should be expected in the future?. Enferm Infecc Microbiol Clin 32 (Suppl. 4:17–23 [View Article][PubMed]
    [Google Scholar]
  13. Papadimitriou-Olivgeris M., Bartzavali C., Christofidou M., Bereksi N., Hey J., Zambardi G., Spiliopoulou I. 2014; Performance of chromID® CARBA medium for carbapenemases-producing Enterobacteriaceae detection during rectal screening. Eur J Clin Microbiol Infect Dis 33:35–40 [View Article][PubMed]
    [Google Scholar]
  14. Pasteran F., Veliz O., Faccone D., Guerriero L., Rapoport M., Mendez T., Corso A. 2011; A simple test for the detection of KPC and metallo-β-lactamase carbapenemase-producing Pseudomonas aeruginosa isolates with the use of meropenem disks supplemented with aminophenylboronic acid, dipicolinic acid and cloxacillin. Clin Microbiol Infect 17:1438–1441 [View Article][PubMed]
    [Google Scholar]
  15. Psichogiou M., Tassios P.T., Avlamis A., Stefanou I., Kosmidis C., Platsouka E., Paniara O., Xanthaki A., Toutouza M., other authors. 2008; Ongoing epidemic of blaVIM-1-positive Klebsiella pneumoniae in Athens, Greece: a prospective survey. J Antimicrob Chemother 61:59–63 [View Article][PubMed]
    [Google Scholar]
  16. Samra Z., Bahar J., Madar-Shapiro L., Aziz N., Israel S., Bishara J. 2008; Evaluation of CHROMagar KPC for rapid detection of carbapenem-resistant Enterobacteriaceae . J Clin Microbiol 46:3110–3111 [View Article][PubMed]
    [Google Scholar]
  17. Shibata N., Doi Y., Yamane K., Yagi T., Kurokawa H., Shibayama K., Kato H., Kai K., Arakawa Y. 2003; PCR typing of genetic determinants for metallo-beta-lactamases and integrases carried by gram-negative bacteria isolated in Japan, with focus on the class 3 integron. J Clin Microbiol 41:5407–5413 [View Article][PubMed]
    [Google Scholar]
  18. Thomson K.S. 2010; Extended-spectrum-beta-lactamase. AmpC, and carbapenemase issues. J Clin Microbiol 48:1019–1025 [View Article][PubMed]
    [Google Scholar]
  19. Vasoo S., Cunningham S.A., Kohner P.C., Simner P.J., Mandrekar J.N., Lolans K., Hayden M.K., Patel R. 2013; Comparison of a novel, rapid chromogenic biochemical assay, the Carba NP test, with the modified Hodge test for detection of carbapenemase-producing Gram-negative bacilli. J Clin Microbiol 51:3097–3101 [View Article][PubMed]
    [Google Scholar]
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