评估用于生化检测产碳青霉烯酶肠杆菌科细菌的RAPIDEC® CARBA NP、Rapid CARB Screen®和Carba NP检测方法。
Evaluation of the RAPIDEC® CARBA NP, the Rapid CARB Screen® and the Carba NP test for biochemical detection of carbapenemase-producing Enterobacteriaceae.
作者信息
Dortet Laurent, Agathine Aurélie, Naas Thierry, Cuzon Gaëlle, Poirel Laurent, Nordmann Patrice
机构信息
Associated French National Reference Center for Antibiotic Resistance, Le Kremlin-Bicêtre, France Research Unit 'Structure, dynamic, function and expression of broad spectrum β-lactamases', Faculty of Medicine, University of Paris-Sud, Le Kremlin-Bicêtre, France Department of Bacteriology-Parasitology-Hygiene, Hôpital de Bicêtre, Assistance Publique - Hôpitaux de Paris, Le Kremlin-Bicêtre, France.
Research Unit 'Structure, dynamic, function and expression of broad spectrum β-lactamases', Faculty of Medicine, University of Paris-Sud, Le Kremlin-Bicêtre, France Department of Bacteriology-Parasitology-Hygiene, Hôpital de Bicêtre, Assistance Publique - Hôpitaux de Paris, Le Kremlin-Bicêtre, France.
出版信息
J Antimicrob Chemother. 2015 Nov;70(11):3014-22. doi: 10.1093/jac/dkv213. Epub 2015 Aug 9.
OBJECTIVES
The objective of this study was the evaluation of the performance of two commercially available biochemical tests for the rapid detection of carbapenemase-producing Enterobacteriaceae compared with a home-made technique.
METHODS
A collection of 150 enterobacterial isolates, including 132 isolates with decreased susceptibility to at least one carbapenem molecule, were tested for carbapenemase activity using the RAPIDEC(®) CARBA NP (bioMérieux), the Rapid CARB Screen(®) (Rosco Diagnostica) and the home-made Carba NP test. This strain collection included 55 non-carbapenemase producers, 21 KPC producers, 21 NDM producers, 17 VIM producers, 11 IMP producers, 16 OXA-48 producers and 9 OXA-48-like producers (OXA-162, OXA-181, OXA-204, OXA-232 and OXA-244).
RESULTS
The RAPIDEC(®) CARBA NP detected all carbapenemase producers except a single OXA-244 producer. Using the Rapid CARB Screen(®), one KPC-2, two NDM-1, one OXA-48 and five OXA-48 variant producers gave equivocal results and one OXA-244 producer was not detected. Using the Carba NP test, the same OXA-244 producer was not detected and one OXA-181 producer and one OXA-244 producer gave equivocal results. Sensitivity and specificity were 99% (95% CI 94.3%-99.8%) and 100% (95% CI 93.5%-100%), respectively, for the RAPIDEC(®) CARBA NP test, 89.5% (95% CI 81.7%-94.2%) and 70.9% (95% CI 57.9%-81.2%) for the Rapid CARB Screen(®) and 96.8% (95% CI 91.1%-98.9%) and 100% (95% CI 93.5%-100%) for the Carba NP test. The impact of the use of an adequate bacterial inoculum for obtaining the optimal performance with the RAPIDEC(®) CARBA NP was noted.
CONCLUSIONS
The RAPIDEC(®) CARBA NP possesses the best performance for rapid and efficient detection of carbapenemase-producing Enterobacteriaceae.
目的
本研究的目的是评估两种市售生化检测方法在快速检测产碳青霉烯酶肠杆菌科细菌方面的性能，并与一种自制技术进行比较。
方法
收集了150株肠杆菌分离株，其中包括132株对至少一种碳青霉烯类分子敏感性降低的分离株，使用RAPIDEC(®) CARBA NP（生物梅里埃公司）、Rapid CARB Screen(®)（罗斯科诊断公司）和自制的Carba NP检测法检测其碳青霉烯酶活性。该菌株集合包括55株非碳青霉烯酶生产者、21株KPC生产者、21株NDM生产者、17株VIM生产者、11株IMP生产者、16株OXA - 48生产者和9株OXA - 48样生产者（OXA - 162、OXA - 181、OXA - 204、OXA - 232和OXA - 244）。
结果
RAPIDEC(®) CARBA NP检测出了所有碳青霉烯酶生产者，但有一株OXA - 244生产者未被检测到。使用Rapid CARB Screen(®)时，一株KPC - 2、两株NDM - 1、一株OXA - 48和五株OXA - 48变异生产者结果不明确，一株OXA - 244生产者未被检测到。使用Carba NP检测法时，同一株OXA - 244生产者未被检测到，一株OXA - 181生产者和一株OXA - 244生产者结果不明确。RAPIDEC(®) CARBA NP检测法的敏感性和特异性分别为99%（95%可信区间94.3% - 99.8%）和100%（95%可信区间93.5% - 100%），Rapid CARB Screen(®)为89.5%（95%可信区间81.7% - 94.2%）和70.9%（95%可信区间57.9% - 81.2%），Carba NP检测法为96.8%（95%可信区间91.1% - 98.9%）和100%（95%可信区间93.5% - 100%）。注意到使用适当的细菌接种量对获得RAPIDEC(®) CARBA NP的最佳性能的影响。
结论
RAPIDEC(®) CARBA NP在快速有效检测产碳青霉烯酶肠杆菌科细菌方面具有最佳性能。
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