A Pilot Study on Carbapenemase Detection: Do We See the Same Level of Agreement as with the CLSI Observations

碳青霉烯酶检测的初步研究:我们是否看到了与 CLSI 观察结果相同的一致性水平

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作者:Agila Kumari Pragasam, Rani Diana Sahni, Shalini Anandan, Archa Sharma, Radha Gopi, Noorjahan Hadibasha, Priya Gunasekaran, Balaji Veeraraghavan

Aim

To evaluate the usefulness of CarbaNP in an Indian setting. Materials and

Conclusion

This observation was more than what was reported in CLSI guidelines. Therefore, it is advisable to evaluate an assay for better laboratory diagnosis at respective regions.

Methods

A total of 260 isolates of carbapenem resistant E.coli (n=57), Klebsiella spp. (n=85), Pseudomonas aeruginosa (n=60), and Acinetobacter baumannii (58) isolated from clinical specimens between 2012-2014 at the Christian Medical College, Vellore were included in the study. All the carbapenem resistant isolates were subjected to CarbaNP, MHT and multiplex PCR for detection of carbapenemase genes.

Results

CarbaNP was found to be positive in 88% (n=50/57), 81% (n=69/51), 38% (n=23/60) and 81% (n=47/58) for E.coli, Klebsiella spp., P. aeruginosa, and A. baumannii respectively. While in MHT it showed, 89% (n=51/57) and 81 % (n=69/85) for E.coli and Klebsiella spp. respectively. In P.aeruginosa, synergy testing of imipenem plus cloxacillin showed that, 65% of CarbaNP negatives were ampC producers. Overall, the sensitivity and specificity of CarbaNP was found to be 94% and 100 for bla NDM; 77% and 100 % for bla OXA-48 like producers and 81% and 100% for CarbAcinetoNP respectively.

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