Pancotto Lisiane Rech, Nodari Carolina Silva, Rozales Franciéli Pedrotti, Soldi Tatiane, Siqueira Carolina Gomes, Freitas Ana Lúcia, Barth Afonso Luís
Hospital de Clínicas de Porto Alegre, Laboratório de Pesquisa em Resistência Bacteriana (LABRESIS), Porto Alegre, RS, Brazil.
Hospital de Clínicas de Porto Alegre, Laboratório de Pesquisa em Resistência Bacteriana (LABRESIS), Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Farmacêuticas, Porto Alegre, RS, Brazil.
Braz J Microbiol. 2018 Oct-Dec;49(4):914-918. doi: 10.1016/j.bjm.2018.07.002. Epub 2018 Aug 16.
The global emergence of carbapenemases led to the need of developing new methods for their rapid detection. The aim of this study was to evaluate the performance of the rapid tests for carbapenemase-producing and non-producing Enterobacteriaceae. Carbapenem non-susceptible Enterobacteriaceae from a surveillance study submitted to a multiplex real time PCR for carbapenemase detection were included in this study. The isolates were subjected to the rapid phenotypic tests Carba NP, Blue-Carba and Carbapenem Inactivation Method (CIM). A total of 83 carbapenemase-producing (43) and non-producing (40) isolates were included in the study. The sensitivity/specificity were 62.7%/97.5%, 95.3%/100%, and 74.4%/97.5% for Carba NP, Blue-Carba and CIM, respectively. Both Carba NP and Blue-Carba presented their final results after 75min of incubation; the final results for CIM were obtained only after 8h. Failure to detect OXA-370 carbapenemase was the main problem for Carba NP and CIM assays. As the Blue-Carba presented the highest sensitivity, it can be considered the best screening test. Conversely, CIM might be the easiest to perform, as it does not require special reagents. The early detection of carbapenemases aids to establish infection control measures and prevent carbapenemases to spread reducing the risk of healthcare associated infections and therapeutic failure.
碳青霉烯酶在全球范围内的出现促使人们需要开发新的快速检测方法。本研究的目的是评估用于检测产碳青霉烯酶和不产碳青霉烯酶的肠杆菌科细菌的快速检测方法的性能。本研究纳入了一项监测研究中对碳青霉烯酶检测进行多重实时PCR的碳青霉烯不敏感肠杆菌科细菌。对分离株进行了快速表型检测，即Carba NP、Blue-Carba和碳青霉烯灭活法（CIM）。本研究共纳入了83株产碳青霉烯酶（43株）和不产碳青霉烯酶（40株）的分离株。Carba NP、Blue-Carba和CIM的敏感性/特异性分别为62.7%/97.5%、95.3%/100%和74.4%/97.5%。Carba NP和Blue-Carba在孵育75分钟后得出最终结果；CIM的最终结果仅在8小时后获得。无法检测到OXA-370碳青霉烯酶是Carba NP和CIM检测的主要问题。由于Blue-Carba具有最高的敏感性，它可被认为是最佳的筛查检测方法。相反，CIM可能是最易于操作的，因为它不需要特殊试剂。碳青霉烯酶的早期检测有助于建立感染控制措施，并防止碳青霉烯酶传播，从而降低医疗相关感染和治疗失败的风险。
