Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam.
Dinh Tien Hoang Institute of Medicine, Ha Noi, Vietnam.
Microbiologyopen. 2020 Dec;9(12):e1130. doi: 10.1002/mbo3.1130. Epub 2020 Nov 9.
To assess a cost-effective in-house selective plate formula for actively screening carbapenem-resistant Enterobacteriaceae (CRE).
The in-house formula included CHROMagar Orientation, meropenem, and ingredients present in the Mac-Conkey formula, such as bile salts and crystal violet (pH 6.9-7.2). American Type Culture Collection strains and 200 clinical strains were used to validate the plate formula. The CRE plates had a sensitivity of 97.4% and a specificity of 98.8% with ATCC andor clinical strains used in the quality control procedure. A point prevalence survey among the 18 inpatients at Viet-Tiep hospital ICU using fecal swabs plated at the in-house agar plate showed a CRE prevalence of 44.4%.
The in-house plate had high sensitivity and specificity, particularly for Escherichia coli and the KESC group (Klebsiella spp., Enterobacter spp., Serratia marscescens, and Citrobacter spp.), and it may be widely applied as an alternative to other ready-to-use commercial plates.
The formula developed in the present study may facilitate the early detection and isolation of CRE and decrease transmission, particularly in low- and middle-income countries with a high rate of CRE colonization and limited access to ready-to-use commercial plates.
评估一种经济有效的内部选择性平板配方，用于主动筛选耐碳青霉烯肠杆菌科（CRE）。
内部配方包括 CHROMagar Orientation、美罗培南和 Mac-Conkey 配方中的胆汁盐和结晶紫等成分（pH6.9-7.2）。使用美国典型培养物保藏中心菌株和 200 株临床菌株对平板配方进行验证。该 CRE 平板对 ATCC 和/或质量控制程序中使用的临床菌株的灵敏度为 97.4%，特异性为 98.8%。在使用粪便拭子对 18 名越捷医院 ICU 住院患者进行的一项点现患率调查中，使用内部琼脂平板进行平板接种的 CRE 现患率为 44.4%。
内部平板具有较高的灵敏度和特异性，特别是对大肠埃希菌和 KESC 组（肺炎克雷伯菌、肠杆菌属、马塞肠杆菌和柠檬酸杆菌属），它可能广泛应用于替代其他即用型商业平板。
本研究中开发的配方可能有助于早期检测和分离 CRE，并减少传播，特别是在 CRE 定植率高且无法获得即用型商业平板的中低收入国家。
