Department of Medical Microbiology, University Medical Centre Utrecht, Room G04-614, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands,
Eur J Clin Microbiol Infect Dis. 2013 Nov;32(11):1445-9. doi: 10.1007/s10096-013-1896-7. Epub 2013 Jun 2.
The adequate detection of carbapenemase-producing Enterobacteriaceae (CPE) is essential for adequate antibiotic therapy and for infection control purposes, especially in an outbreak setting. Selective agars play an important role in the detection of CPE. The Oxoid Brilliance™ CRE Agar (Thermo Fisher Scientific) was evaluated for the detection of CPE using 255 non-repetitive Enterobacteriaceae isolates, including 95 CPE (36 KPC, 4 KPC plus VIM, 4 NDM, 6 GIM, 20 VIM, and 25 OXA-48-producing isolates). The sensitivity of the CRE agar for the detection of CPE was 94 % (89/95), but differed per carbapenemase gene (100 % for KPC, NDM, and GIM, 90 % for VIM, and 84 % for OXA-48-producing isolates). The specificity of the CRE agar was 71 %, due to the growth of AmpC- and/or ESBL-producing isolates. The CRE agar is a sensitive tool for the detection of KPC and metallo-carbapenemase-producing Enterobacteriaceae, although the detection of OXA-48 producers is less optimal. The relatively low specificity requires confirmation of carbapenemase production for isolates recovered from the CRE agar.
产碳青霉烯酶肠杆菌科（CPE）的充分检测对于适当的抗生素治疗和感染控制目的至关重要，尤其是在爆发情况下。选择性琼脂在 CPE 的检测中起着重要作用。Oxoid Brilliance™ CRE 琼脂（赛默飞世尔科技）用于检测包括 95 株 CPE（36 株 KPC、4 株 KPC 加 VIM、4 株 NDM、6 株 GIM、20 株 VIM 和 25 株产 OXA-48 株）在内的 255 株非重复肠杆菌科分离株。CRE 琼脂检测 CPE 的敏感性为 94%（89/95），但按碳青霉烯酶基因有所不同（KPC、NDM 和 GIM 为 100%，VIM 为 90%，产 OXA-48 株为 84%）。由于 AmpC 和/或 ESBL 产生菌的生长，CRE 琼脂的特异性为 71%。CRE 琼脂是检测 KPC 和金属碳青霉烯酶产生肠杆菌科的敏感工具，尽管对产 OXA-48 株的检测效果较差。相对较低的特异性要求对从 CRE 琼脂中回收的分离株的碳青霉烯酶产生进行确认。
