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对用于检测耐亚胺培南菌株中金属β-内酰胺酶的不同表型试验的评估

Evaluation of different phenotypic tests for detection of metallo-β-lactamases in imipenem-resistant .

作者信息

Sachdeva Rohit, Sharma Babita, Sharma Rajni

机构信息

Department of Microbiology, Veer Chandra Singh Garhwali Government Medical Science and Research Institute, Srinagar, Uttarakhand, India.

Department of Microbiology, Sawai ManSingh Medical College, Jaipur, Rajasthan, India.

出版信息

J Lab Physicians. 2017 Oct-Dec;9(4):249-253. doi: 10.4103/JLP.JLP_118_16.

DOI:10.4103/JLP.JLP_118_16
PMID:28966485
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5607752/
Abstract

PURPOSE

causes a wide spectrum of infections including bacteremia, pneumonia, urinary tract infection, etc., Metallo-beta-lactamase (MBL) producing is an emerging threat and cause of concern as they have emerged as one of the most feared resistance mechanisms. This study was designed to know the prevalence of MBL production in and to evaluate the four phenotypic tests for detection of MBL production in imipenem-resistant clinical isolates of .

METHODS

Totally, 800 isolates of isolated from various clinical samples were evaluated for carbapenem resistance and MBL production. All imipenem-resistant strains were tested for carabapenemase production by modified Hodge test. Screening for MBL production was done by double-disc synergy test and combined disc test (CDT). Confirmation of MBL production was done by the E-test (Ab BioDisk, Solna, Sweden).

RESULTS

Out of the 800 isolates of , 250 isolates were found resistant to imipenem. Based on the results of E-test, 147 (18.37%) isolates of were positive for MBL production. The CDT has the highest sensitivity and specificity for the detection of MBL production as compared to other tests.

CONCLUSION

The results of this study are indicative that MBL production is an important mechanism of carbapenem resistance among . Use of simple screening test like CDT will be crucial step toward large-scale monitoring of these emerging resistant determinants. Phenotypic test for MBL production has to be standardized, and all the isolates should be routinely screened for MBL production.

摘要

目的

可引发多种感染，包括菌血症、肺炎、尿路感染等。产金属β-内酰胺酶（MBL）是一种新出现的威胁，令人担忧，因为它们已成为最可怕的耐药机制之一。本研究旨在了解[具体细菌名称未给出]中产MBL的流行情况，并评估四种表型试验用于检测[具体细菌名称未给出]对亚胺培南耐药的临床分离株中产MBL的情况。

方法

总共对从各种临床样本中分离出的800株[具体细菌名称未给出]进行了碳青霉烯耐药性和MBL产生情况的评估。所有对亚胺培南耐药的菌株都通过改良 Hodge试验检测碳青霉烯酶的产生。通过双碟协同试验和联合碟片试验（CDT）进行MBL产生情况的筛查。通过E试验（瑞典索尔纳的阿博生物盘公司）对MBL产生情况进行确认。

结果

在800株[具体细菌名称未给出]分离株中，发现250株对亚胺培南耐药。根据E试验结果，147株（18.37%）[具体细菌名称未给出]分离株MBL产生呈阳性。与其他试验相比，CDT对检测MBL产生具有最高的敏感性和特异性。

结论

本研究结果表明，MBL产生是[具体细菌名称未给出]中碳青霉烯耐药的重要机制。使用如CDT这样的简单筛查试验将是对这些新出现的耐药决定因素进行大规模监测的关键步骤。MBL产生的表型试验必须标准化，并且所有分离株都应常规筛查MBL产生情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d22/5607752/3f6fb738ac51/JLP-9-249-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d22/5607752/3f6fb738ac51/JLP-9-249-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d22/5607752/3f6fb738ac51/JLP-9-249-g002.jpg

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