Role of double concentration combined modified carbapenem inactivation test for screening CRE

doi:10.3969/j.issn.1673-8640.2020.10.004

Abstract

Abstract:

Objective To evaluate the role of double concentration combined modified carbapenem inactivation method（mCIM） for screening carbapenem-resistant Enterobacteriaceae（CRE）. Methods Based on the drug susceptibility test of VITEK 2 Compact N335 card,231 isolates of Enterobacteriaceae isolated from clinical samples were screened for CRE by double concentration combined mCIM. Results Totally,52 isolates of CRE were screened by VITEK 2 Compact N335 card,179 isolates were negative,and the positive rate was 22.5%. Totally,52 isolates of CRE were screened by mCIM. A total of 53 isolates of CRE were screened by double concentration combined mCIM,178 isolates were negative,and the positive rate was 22.9%. Based on the durg susceptibility test of VITEK 2 Compact N335 card,the consistency rate,sensitivity and specificity were 98.7%,98.1% and 98.9%,respectively. A total of 52 isolates with positive mCIM results were continued to do ethylenediamine tetraacetic acid-modified carbapenem inactivation method（eCIM）. The results showed that 13 isolates of Enterobacteriaceae were metallo-β-lactamase positive,and the positive rate of carbapenemases was 25%. Conclusions The double concentration combined mCIM for CRE screening has the advantages of simple operation,no need for special instruments and easy observation of results. It is suitable for using in all level microbiological laboratories. It is necessary for mCIM positive isolates to do eCIM again,which is conducive to individualized drug use in clinic.

Key words: Double concentration screening method, Modified carbapenem inactivation method, Carbapenem-resistant Enterobacteriaceae, ethylenediamine tetraacetic acid-modified carbapenem inactivation method

CLC Number:

R446.5

LI Shirong, LIN Lijing, JIANG Xiaofei, GUAN Ming. Role of double concentration combined modified carbapenem inactivation test for screening CRE[J]. Laboratory Medicine, 2020, 35(10): 979-982.

Figures/Tables 1

References 14

[1]	Centers for Disease Control and Prevention (CDC). Facility guidance for control of carbapenem-resistant Enterobacteriaceae(CRE)[R]. Atlanta:U. S. Department of Health and Human Services,2018.
[2]	廖兰凯,廖雪莲,康焰. 耐碳青霉烯类肠杆菌防控现状及研究进展[J]. 中华医院感染学杂志,2019,29(11):1750-1755.
[3]	Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing[S]. M100-S29,CLSI,2019.
[4]	PATEL G,BONOMO R A.Status report on carbapenemases:challenges and prospects[J]. Expert Rev Anti Infect Ther,2011,9(5):555-570.
[5]	孙康德,陈旭,虞中敏,等. 碳青霉烯类耐药克雷伯菌属细菌的药物敏感性及同源性分析[J]. 检验医学,2014,29(11):1136-1140.
[6]	SUN Y,LI M,CHEN L,et al.Prevalence and molecular characterization of carbapenemase-producing gram-negative bacteria from a university hospital in China[J]. Infect Dis(Lond),2016,48(2):138-146.
[7]	IOVLEVA A,DOI Y. Carbapenem-resistant Enterobacteriaceae[J]. Clin Lab Med,2017,37(2):303-315.
[8]	闫文娟,李轶,王山梅,等. 耐碳青霉烯类抗菌药物大肠埃希菌耐药机制的研究[J]. 检验医学,2016,31(1):56-60.
[9]	国家卫生计生委合理用药专家委员会,全国细菌耐药监测网. 2018 年全国细菌耐药监测报告[J].中国合理用药探索,2020,17(1):1-10.
[10]	DORTET L,BRÉCHARD L,POIREL L,et al. Impact of the isolation medium for detection of carbapenemase-producing Enterobacteriaceae using an updated version of the Carba NP test[J]. J Med Microbiol,2014,63(Pt 5):772-776.
[11]	MITRA S,KAZI M,PANCHAL M,et al. Evaluation of Carba NP test for rapid detection of carbapenemase producing Enterobacteriaceae[J]. Indian J Med Microbiol,2015,33(4):603-606.
[12]	DORTET L,AGATHINE A,NAAS T,et al.Evaluation of the RAPIDEC® CARBA NP,the Rapid CARB Screen® and the Carba NP test for biochemical detection of carbapenemase-producing Enterobacteriaceae[J]. J Antimicrob Chemother,2015,70(11):3014-3022.
[13]	KAASE M,SZABADOS F,WASSILL L,et al.Detection of carbapenemases in Enterobacteriaceae by a commercial multiplex PCR[J]. J Clin Microbiol,2012,50(9):3115-3118.
[14]	LUTGRING J D,LIMBAGO B M.The problem of carbapenemase-producing-carbapenem-resistant- Enterobacteriaceae detection[J]. J Clin Microbiol,2016,54(3):529-534.

菌株编号	仪器法	双浓度筛查法	mCIM	双浓度联合mCIM
1~49	+	+	+	+
50（阴沟肠杆菌）	+	+	-	+
51（肺炎克雷伯菌）	+	2 μg/mL生长、4 μg/mL不生长	-	-
52（肺炎克雷伯菌）	+	2 μg/mL生长、4 μg/mL不生长	+	+
53（肺炎克雷伯菌）	-	2 μg/mL生长、4 μg/mL不生长	+	+
54（大肠埃希菌）	-	2 μg/mL生长、4 μg/mL不生长	+	+
55~59	-	2 μg/mL生长、4 μg/mL不生长	-	-
60~231	-	-	-	-

菌株编号	仪器法	双浓度筛查法	mCIM	双浓度联合mCIM
1~49	+	+	+	+
50（阴沟肠杆菌）	+	+	-	+
51（肺炎克雷伯菌）	+	2 μg/mL生长、4 μg/mL不生长	-	-
52（肺炎克雷伯菌）	+	2 μg/mL生长、4 μg/mL不生长	+	+
53（肺炎克雷伯菌）	-	2 μg/mL生长、4 μg/mL不生长	+	+
54（大肠埃希菌）	-	2 μg/mL生长、4 μg/mL不生长	+	+
55~59	-	2 μg/mL生长、4 μg/mL不生长	-	-
60~231	-	-	-	-