Disk carbapenemase test for the rapid detection of KPC-, NDM-, and other metallo-β-lactamase-producing gram-negative bacilli

Hyunsoo Kim, Ji Yeon Sung, DongEun Yong, Seokhoon Jeong, Wonkeun Song, Kyungwon Lee, Yunsop Chong

Research output: Contribution to journalArticle

Abstract

Background: Rapid detection of carbapenemase-producing gram-negative bacilli (GNB) is required for optimal treatment of infected patients. We developed and assessed a new disk carbapenemase test (DCT). Methods: Paper disks containing 0.3 mg of imipenem and bromothymol blue indicator were developed, and the performance of the DCT were evaluated by using 742 strains of GNB with or without carbapenemases. Results: The paper disks were simple to prepare, and the dried disks were stable at -20° C and at 4° C. The DCT detected 212 of 215 strains (98.6% sensitivity with 95% confidence interval [CI] 96.0-99.5%) of GNB with known class A (KPC and Sme) and class B (NDM, IMP, VIM, and SIM) carbapenemases within 60 min, but failed to detect GES-5 carbapenemase. The DCT also detected all two Escherichia coli isolates with OXA-48, but failed to detect GNB with OXA-232, and other OXA carbapenemases. The DCT showed 100% specificity (95% CI, 99.2-100%) in the test of 448 imipenem-nonsusceptible, but carbapenemase genes not tested, clinical isolates of GNB. Conclusions: The DCT is simple and can be easily performed, even in small laboratories, for the rapid detection of GNB with KPC, NDM and the majority of IMP, VIM, and SIM carbapenemases.

Original languageEnglish
Pages (from-to)434-440
Number of pages7
JournalAnnals of laboratory medicine
Volume36
Issue number5
DOIs
Publication statusPublished - 2016 Sep 1

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Bacilli
Bacillus
Inosine Monophosphate
Imipenem
Bromthymol Blue
Confidence Intervals
carbapenemase
Escherichia coli
Genes

All Science Journal Classification (ASJC) codes

  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

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title = "Disk carbapenemase test for the rapid detection of KPC-, NDM-, and other metallo-β-lactamase-producing gram-negative bacilli",
abstract = "Background: Rapid detection of carbapenemase-producing gram-negative bacilli (GNB) is required for optimal treatment of infected patients. We developed and assessed a new disk carbapenemase test (DCT). Methods: Paper disks containing 0.3 mg of imipenem and bromothymol blue indicator were developed, and the performance of the DCT were evaluated by using 742 strains of GNB with or without carbapenemases. Results: The paper disks were simple to prepare, and the dried disks were stable at -20° C and at 4° C. The DCT detected 212 of 215 strains (98.6{\%} sensitivity with 95{\%} confidence interval [CI] 96.0-99.5{\%}) of GNB with known class A (KPC and Sme) and class B (NDM, IMP, VIM, and SIM) carbapenemases within 60 min, but failed to detect GES-5 carbapenemase. The DCT also detected all two Escherichia coli isolates with OXA-48, but failed to detect GNB with OXA-232, and other OXA carbapenemases. The DCT showed 100{\%} specificity (95{\%} CI, 99.2-100{\%}) in the test of 448 imipenem-nonsusceptible, but carbapenemase genes not tested, clinical isolates of GNB. Conclusions: The DCT is simple and can be easily performed, even in small laboratories, for the rapid detection of GNB with KPC, NDM and the majority of IMP, VIM, and SIM carbapenemases.",
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Disk carbapenemase test for the rapid detection of KPC-, NDM-, and other metallo-β-lactamase-producing gram-negative bacilli. / Kim, Hyunsoo; Sung, Ji Yeon; Yong, DongEun; Jeong, Seokhoon; Song, Wonkeun; Lee, Kyungwon; Chong, Yunsop.

In: Annals of laboratory medicine, Vol. 36, No. 5, 01.09.2016, p. 434-440.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Disk carbapenemase test for the rapid detection of KPC-, NDM-, and other metallo-β-lactamase-producing gram-negative bacilli

AU - Kim, Hyunsoo

AU - Sung, Ji Yeon

AU - Yong, DongEun

AU - Jeong, Seokhoon

AU - Song, Wonkeun

AU - Lee, Kyungwon

AU - Chong, Yunsop

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Background: Rapid detection of carbapenemase-producing gram-negative bacilli (GNB) is required for optimal treatment of infected patients. We developed and assessed a new disk carbapenemase test (DCT). Methods: Paper disks containing 0.3 mg of imipenem and bromothymol blue indicator were developed, and the performance of the DCT were evaluated by using 742 strains of GNB with or without carbapenemases. Results: The paper disks were simple to prepare, and the dried disks were stable at -20° C and at 4° C. The DCT detected 212 of 215 strains (98.6% sensitivity with 95% confidence interval [CI] 96.0-99.5%) of GNB with known class A (KPC and Sme) and class B (NDM, IMP, VIM, and SIM) carbapenemases within 60 min, but failed to detect GES-5 carbapenemase. The DCT also detected all two Escherichia coli isolates with OXA-48, but failed to detect GNB with OXA-232, and other OXA carbapenemases. The DCT showed 100% specificity (95% CI, 99.2-100%) in the test of 448 imipenem-nonsusceptible, but carbapenemase genes not tested, clinical isolates of GNB. Conclusions: The DCT is simple and can be easily performed, even in small laboratories, for the rapid detection of GNB with KPC, NDM and the majority of IMP, VIM, and SIM carbapenemases.

AB - Background: Rapid detection of carbapenemase-producing gram-negative bacilli (GNB) is required for optimal treatment of infected patients. We developed and assessed a new disk carbapenemase test (DCT). Methods: Paper disks containing 0.3 mg of imipenem and bromothymol blue indicator were developed, and the performance of the DCT were evaluated by using 742 strains of GNB with or without carbapenemases. Results: The paper disks were simple to prepare, and the dried disks were stable at -20° C and at 4° C. The DCT detected 212 of 215 strains (98.6% sensitivity with 95% confidence interval [CI] 96.0-99.5%) of GNB with known class A (KPC and Sme) and class B (NDM, IMP, VIM, and SIM) carbapenemases within 60 min, but failed to detect GES-5 carbapenemase. The DCT also detected all two Escherichia coli isolates with OXA-48, but failed to detect GNB with OXA-232, and other OXA carbapenemases. The DCT showed 100% specificity (95% CI, 99.2-100%) in the test of 448 imipenem-nonsusceptible, but carbapenemase genes not tested, clinical isolates of GNB. Conclusions: The DCT is simple and can be easily performed, even in small laboratories, for the rapid detection of GNB with KPC, NDM and the majority of IMP, VIM, and SIM carbapenemases.

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