Division of Infectious Diseases, School of Medicine, University of Patras, Patras, Greece.
Eur J Clin Microbiol Infect Dis. 2014 Jan;33(1):35-40. doi: 10.1007/s10096-013-1925-6. Epub 2013 Aug 4.
Chromogenic chromID® CARBA medium was compared with CDC method and MacConkey agar with imipenem for its performance in detecting carbapenemase-producing Enterobacteriaceae (CPE) during a faecal screening surveillance program. Double rectal swabs were collected from patients hospitalized in the ICU. One swab was inoculated onto the solid media chromID® CARBA and MacConkey agar with imipenem, while the other was tested according to CDC protocol. Suspected colonies from all procedures were identified to species level and tested for their susceptibility to carbapenems by phenotypic tests. All carbapenem non-susceptible isolates were tested by the modified Hodge test (MHT) and synergy tests. Positive results were confirmed by PCR testing for carbapenemase gene detection. Performance of all three procedures applied was statistically analyzed as compared to MHT and PCR results for the presence of carbapenemase-encoding genes. Out of 177 rectal samples tested, 86 samples were found to contain one or more CPE verified by molecular detection of carbapenemase encoding genes among isolated Enterobacteriaceae. Sensitivity of chromID® CARBA was 96.5 % in clinical samples. Specificity was 91.2 % at the reading level and 100.0 % after Gram staining. chromID® CARBA performed with high accuracy among the phenotypic methods applied, giving early results.
显色 chromID® CARBA 培养基与 CDC 方法和含亚胺培南的麦康凯琼脂在粪便筛查监测计划中用于检测产碳青霉烯酶肠杆菌科(CPE)的性能进行了比较。对 ICU 住院患者进行双直肠拭子采集。一个拭子接种到固体培养基 chromID® CARBA 和含亚胺培南的麦康凯琼脂上,而另一个拭子则根据 CDC 方案进行测试。所有程序的可疑菌落均鉴定到种水平,并通过表型试验测试其对碳青霉烯类药物的敏感性。所有碳青霉烯类药物不敏感的分离株均通过改良 Hodge 试验(MHT)和协同试验进行测试。阳性结果通过检测碳青霉烯酶基因的 PCR 测试进行确认。与 MHT 和 PCR 检测碳青霉烯酶基因的结果相比,对所有三种方法的应用进行了统计学分析。在检测的 177 个直肠样本中,86 个样本通过分离肠杆菌科的碳青霉烯酶编码基因的分子检测被证实含有一种或多种 CPE。chromID® CARBA 在临床样本中的敏感性为 96.5%。在读取水平的特异性为 91.2%,革兰氏染色后为 100.0%。chromID® CARBA 在应用的表型方法中具有很高的准确性,可提供早期结果。