University of Turku, Institute of Biomedicine, Kiinamyllynkatu 10, 20520 Turku, Finland.
University of Turku, Institute of Biomedicine, Kiinamyllynkatu 10, 20520 Turku, Finland.
J Glob Antimicrob Resist. 2020 Sep;22:408-413. doi: 10.1016/j.jgar.2020.04.015. Epub 2020 Apr 26.
Accurte diagnostic methods are crucial for the detection of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E). Besides culture-based gold-standard methods, new molecular gene detection tests are reaching the market. The aim of this study was to investigate the performance of the direct quantitative PCR (qPCR)-based methods Check-Direct ESBL and CPE Screen for BD MAX in relation to traditional culture-based methods for detection of ESBL-E faecal carriage.
Faecal samples were collected from healthy adult volunteers. Samples were cultured on chromogenic ESBL agar plates and were screened for ESBL-producing Escherichia coli and Klebsiella pneumoniae. Confirmed ESBL- and AmpC-producing isolates were further analysed using whole-genome sequencing. In addition, faecal samples were analysed using Check-Direct ESBL and CPE Screen for BD MAX and the results were compared with the gold-standard culture-based method.
Of 176 faecal samples examined, 11 (6.3%) grew ESBL-producing E. coli or K. pneumoniae isolates. Among 173 analysed samples, Check-Direct ESBL Screen for BD MAX detected 22 (12.7%) ESBL-positive samples. No carbapenemase-producing isolates were detected. Two culture-positive samples remained negative with Check-Direct ESBL Screen for BD MAX. Culture-negative but qPCR-positive discrepancy was observed in 12 samples (6.9%). Altogether, concordant results were obtained for 158 samples (91.3%; 9 positive and 149 negative).
Check-Direct ESBL Screen for BD MAX is a fast screening method for ESBL carriage. However, several discrepant results were observed, which hinders interpretation. More clinical samples should be tested in combination with culture to evaluate the true benefits of this method.
准确的诊断方法对于检测产超广谱β-内酰胺酶肠杆菌科（ESBL-E）至关重要。除了基于培养的金标准方法外，新的分子基因检测试验也正在推向市场。本研究旨在调查直接定量 PCR（qPCR）检测方法 Check-Direct ESBL 和 CPE Screen for BD MAX 与传统基于培养的方法检测粪便中产 ESBL-E 携带情况的性能。
收集健康成年志愿者的粪便样本。将样本接种于显色 ESBL 琼脂平板上，并筛选产 ESBL 的大肠埃希菌和肺炎克雷伯菌。对确认的 ESBL 和 AmpC 产菌株进一步进行全基因组测序分析。此外，使用 Check-Direct ESBL 和 CPE Screen for BD MAX 对粪便样本进行分析，并将结果与金标准的基于培养的方法进行比较。
在检查的 176 份粪便样本中，有 11 份（6.3%）生长出产 ESBL 的大肠埃希菌或肺炎克雷伯菌分离株。在分析的 173 份样本中，Check-Direct ESBL Screen for BD MAX 检测到 22 份（12.7%）ESBL 阳性样本。未检测到碳青霉烯酶产菌株。Check-Direct ESBL Screen for BD MAX 对 2 份培养阳性样本呈阴性。在 12 份样本中观察到培养阴性但 qPCR 阳性的差异（6.9%）。总共，158 份样本（91.3%；9 份阳性和 149 份阴性）获得一致结果。
Check-Direct ESBL Screen for BD MAX 是一种快速的 ESBL 携带筛查方法。然而，观察到一些不一致的结果，这阻碍了结果的解释。应结合培养物检测更多的临床样本，以评估该方法的真正益处。
