Service de Bactériologie-Virologie, INSERM U914 Emerging Resistance to Antibiotics, Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris, Faculté de Médecine Paris Sud, K.-Bicêtre, France.
J Clin Microbiol. 2012 Sep;50(9):3016-22. doi: 10.1128/JCM.00859-12. Epub 2012 Jul 3.
Enterobacterial strains producing clavulanic-acid-inhibited extended-spectrum β-lactamases (ESBLs) are increasingly reported worldwide. Conventional detection of ESBL production remains time-consuming (24 to 48 h). Therefore, the ESBL NDP (Nordmann/Dortet/Poirel) test was developed for a rapid identification of ESBLs in Enterobacteriaceae. This biochemical test was based on the in vitro detection of a cephalosporin (cefotaxime) hydrolysis that is inhibited by tazobactam addition. The ESBL activity was evidenced by a color change (red to yellow) of a pH indicator (red phenol) due to carboxyl-acid formation resulting from cefotaxime hydrolysis that was reversed by addition of tazobactam (positive test). The ESBL NDP test was applied to cultured strains (215 ESBL producers and 40 ESBL nonproducers). Its sensitivity and specificity were 92.6% and 100%, respectively. Its sensitivity (100%) was excellent for detection of CTX-M producers. A few ESBL producers (n = 16) that remained susceptible to cefotaxime were not detected. The test was also evaluated on spiked blood cultures and showed excellent sensitivity and specificity (100% for both). The test was rapid (less than 1 h) and cost-effective. It can be implemented in any health care facility and is well adapted for infection control purposes in particular.
产克拉维酸抑制型扩展谱β-内酰胺酶（ESBLs）的肠杆菌菌株在世界范围内的报道越来越多。传统的 ESBL 产生检测仍然很耗时（24 至 48 小时）。因此，开发了 ESBL NDP（Nordmann/Dortet/Poirel）试验来快速鉴定肠杆菌科中的 ESBL。这种生化试验基于体外检测头孢菌素（头孢噻肟）水解，该水解被他唑巴坦的加入所抑制。ESBL 活性通过 pH 指示剂（红色酚）的颜色变化（红色变为黄色）来证明，这是由于头孢噻肟水解产生的羧酸形成，加入他唑巴坦后可逆转（阳性试验）。ESBL NDP 试验应用于培养菌株（215 株 ESBL 产生菌和 40 株 ESBL 非产生菌）。其敏感性和特异性分别为 92.6%和 100%。其对 CTX-M 产生菌的检测敏感性（100%）非常出色。少数对头孢噻肟仍敏感的 ESBL 产生菌（n=16）未被检测到。该试验还在加标血培养物上进行了评估，显示出出色的敏感性和特异性（均为 100%）。该试验快速（不到 1 小时）且具有成本效益。它可以在任何医疗机构实施，特别适用于感染控制目的。
