Service de Bactériologie-Virologie, INSERM U914: 'Emerging Resistance to Antibiotics', Hôpital de Bicêtre, Faculté de Médecine Paris Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France.
J Antimicrob Chemother. 2012 Aug;67(8):1865-9. doi: 10.1093/jac/dks156. Epub 2012 May 17.
Carbapenem-resistant Gram-negative bacilli are reported increasingly and represent an emerging public health concern. Laboratory detection of extended-spectrum β-lactamase (ESBL), plasmid-mediated cephalosporinase (pAmpC) and carbapenemase producers remains a challenge for microbiology laboratories and is important to avoid clinical failure due to inappropriate antimicrobial therapy and to prevent nosocomial outbreaks. We evaluated a novel microarray, the 'Check-MDR CT103 array' test (Check-Points, Wageningen, The Netherlands), that employs highly specific DNA markers to identify the β-lactamase genes of ESBLs (TEM, SHV and CTX-M, and discriminates between ESBL and non-ESBL TEM and SHV variants), of pAmpC (CMY-2-like, DHA, FOX, ACC-1, ACT/MIR and CMY-1-like/MOX) and of carbapenemases (KPC, OXA-48, VIM, IMP and NDM).
One-hundred-and-eighty-seven well-characterized Gram-negative bacilli isolates possessing different bla genes were tested. Total DNAs were extracted using a Qiagen DNA mini kit. The 'Check-MDR CT103 array' was used as recommended by the manufacturer.
The system correctly identified representatives of the three ESBL gene families tested, including differentiation between non-ESBL and ESBL TEM and SHV variants. All bla(CTX-M) genes were classified into the appropriate family group (i.e. CTX-M-1 group, CTX-M-2 group, CTX-M-9 group and CTX-M-8/25/26 group). In addition, the clinically relevant plasmid-encoded cephalosporinase and carbapenemase genes were also reliably detected. Specificities and sensitivities of 100% were recorded for most bla genes.
The 'Check-MDR CT103 array' is a powerful high-throughput tool for rapid identification of ESBL, pAmpC and carbapenemase producers in culture. Because of its rapid performance, this platform is a valuable tool for epidemiological or infection control studies.
耐碳青霉烯类革兰阴性杆菌的报告日益增多，成为新出现的公共卫生关注点。实验室检测超广谱β-内酰胺酶（ESBL）、质粒介导头孢菌素酶（pAmpC）和碳青霉烯酶产生菌仍然是微生物学实验室的一项挑战，这对于避免因不适当的抗菌治疗导致临床治疗失败以及预防医院感染爆发非常重要。我们评估了一种新型微阵列，即“Check-MDR CT103 阵列”（Check-Points，荷兰瓦赫宁根）检测（Check-Points，瓦赫宁根，荷兰），该检测使用高度特异性的 DNA 标记来鉴定 ESBL（TEM、SHV 和 CTX-M，并区分 ESBL 和非 ESBL TEM 和 SHV 变体）、pAmpC（CMY-2 样、DHA、FOX、ACC-1、ACT/MIR 和 CMY-1 样/MOX）和碳青霉烯酶（KPC、OXA-48、VIM、IMP 和 NDM）的β-内酰胺酶基因。
对 187 株具有不同 bla 基因的特征明确的革兰氏阴性杆菌分离株进行了检测。使用 Qiagen DNA mini 试剂盒提取总 DNA。按照制造商的建议使用“Check-MDR CT103 阵列”进行检测。
该系统正确鉴定了所测试的三种 ESBL 基因家族的代表，包括区分非 ESBL 和 ESBL TEM 和 SHV 变体。所有 bla(CTX-M)基因均被归类到适当的家族群（即 CTX-M-1 群、CTX-M-2 群、CTX-M-9 群和 CTX-M-8/25/26 群）。此外，还可靠地检测到临床上相关的质粒编码头孢菌素酶和碳青霉烯酶基因。大多数 bla 基因的特异性和敏感性均为 100%。
“Check-MDR CT103 阵列”是一种快速鉴定培养物中 ESBL、pAmpC 和碳青霉烯酶产生菌的高通量工具。由于其快速的性能，该平台是流行病学或感染控制研究的有价值的工具。
