Christina Sharon, Praveena Raveendran, Shahul Mymoonah Risha, Saikumar Chitralekha
Microbiology, Sree Balaji Medical College & Hospital, Bharath Institute of Higher Education and Research, Chennai, IND.
Cureus. 2024 Sep 8;16(9):e68941. doi: 10.7759/cureus.68941. eCollection 2024 Sep.
Background In critically ill patients, carbapenems are often used as the last line of treatment. Carbapenem-resistant (CRE) present an extreme challenge to treatment due to their resistance to various antibiotics. Optimal therapy for patients and infection control relies on the early and accurate diagnosis of these infections. The K.N.I.V.O. Detection K-Set is a newly developed immunological rapid test developed to identify the presence of carbapenemase in Gram-negative bacteria resistant to multiple drugs. Objectives This study evaluates a new K.N.I.V.O. Detection K-Set and its application for the rapid detection of isolates of multidrug-resistant (MDR ) that produce carbapenemase. This test aims to compare the test's performance to the polymerase chain reaction (PCR) method. Methods The study included 150 MDR isolates that were confirmed to be resistant to at least three groups of antibiotics, including carbapenems. The test followed the manufacturer's instructions using the K.N.I.V.O. Detection K-Set. The outcomes were compared with carbapenemase gene detection (bla-KPC, bla-NDM, bla-OXA-48, bla -VIM, and bla -IMP) using the PCR. The K-Set's sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated and studied. Results The K.N.I.V.O. Detection K-Set showed highly effective diagnostic performance with a 97.1% sensitivity, 97.5% specificity, 97.1% positive predictive value, and 98.7% negative predictive value. Seventy-eight of the 150 isolates were proven to be producers of carbapenemase, with 68 of those cases having an accurate identification. The remaining isolates were found to be non-producers. Within 15 minutes, the rapid test provided results. Conclusion The K.N.I.V.O. Detection K-Set is an effective and rapid method for identifying carbapenemase producers among MDR isolates. Its rapid processing time, associated with its high sensitivity and specificity, indicates that it can increase the effectiveness of diagnostic laboratories and better patient care in clinical settings. Implementing such rapid screenings could be vital for controlling the spread of drug-resistant infections and enhancing antimicrobial stewardship. This also ensures that patients receive timely treatment and effective care.
背景 在重症患者中，碳青霉烯类药物常被用作最后一线治疗药物。耐碳青霉烯类肠杆菌科细菌（CRE）由于对多种抗生素耐药，给治疗带来了极大挑战。对患者的最佳治疗及感染控制依赖于对这些感染的早期准确诊断。K.N.I.V.O.检测试剂盒是一种新开发的免疫快速检测方法，用于鉴定对多种药物耐药的革兰氏阴性菌中碳青霉烯酶的存在。目的 本研究评估一种新型K.N.I.V.O.检测试剂盒及其在快速检测产碳青霉烯酶的多重耐药（MDR）菌株中的应用。该检测旨在将其性能与聚合酶链反应（PCR）方法进行比较。方法 本研究纳入了150株多重耐药菌株，这些菌株被证实对至少三类抗生素耐药，包括碳青霉烯类。检测按照制造商的说明使用K.N.I.V.O.检测试剂盒进行。将结果与使用PCR进行的碳青霉烯酶基因检测（bla-KPC、bla-NDM、bla-OXA-48、bla-VIM和bla-IMP）进行比较。计算并研究了该试剂盒的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。结果 K.N.I.V.O.检测试剂盒显示出高效的诊断性能，敏感性为97.1%，特异性为97.5%，阳性预测值为97.1%，阴性预测值为98.7%。150株菌株中有78株被证实为碳青霉烯酶产生菌，其中68例得到准确鉴定。其余菌株被发现为非产生菌。该快速检测在15分钟内给出结果。结论 K.N.I.V.O.检测试剂盒是一种在多重耐药菌株中鉴定碳青霉烯酶产生菌的有效且快速的方法。其快速的处理时间，连同其高敏感性和特异性，表明它可以提高诊断实验室的效率，并在临床环境中更好地护理患者。实施此类快速筛查对于控制耐药感染的传播和加强抗菌药物管理可能至关重要。这也确保患者得到及时治疗和有效护理。
