Modified carbapenem inactivation method/EDTA-carbapenem inactivation method test to evaluate detection ability of carbapenemase and analyzing drug-resistance characteristics of carbapenem-resistant Enterobacteriaceae
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Modified carbapenem inactivation method/EDTA-carbapenem inactivation method test to evaluate detection ability of carbapenemase and analyzing drug-resistance characteristics of carbapenem-resistant Enterobacteriaceae
Journal of Chongqing Medical UniversityVol. 45, Issue 12, Pages: 1809(2020)
作者机构:
1. 华北理工大学附属医院检验科,唐山,063000
2. 中国疾病预防控制中心传染病预防控制所、传染病预防控制国家重点实验室,北京,102206
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Published:2020,
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Huang Junzhi, Dong Aiying, Zhou Haijian, et al. Modified carbapenem inactivation method/EDTA-carbapenem inactivation method test to evaluate detection ability of carbapenemase and analyzing drug-resistance characteristics of carbapenem-resistant Enterobacteriaceae. [J]. Journal of Chongqing Medical University 45(12):1809(2020)
DOI:
Huang Junzhi, Dong Aiying, Zhou Haijian, et al. Modified carbapenem inactivation method/EDTA-carbapenem inactivation method test to evaluate detection ability of carbapenemase and analyzing drug-resistance characteristics of carbapenem-resistant Enterobacteriaceae. [J]. Journal of Chongqing Medical University 45(12):1809(2020)DOI:
Modified carbapenem inactivation method/EDTA-carbapenem inactivation method test to evaluate detection ability of carbapenemase and analyzing drug-resistance characteristics of carbapenem-resistant Enterobacteriaceae
Objective:To evaluate the detection ability of modified carbapenem inactivation method(mCIM)/EDTA-carbapenem inac-tivation method(eCIM) test and modified Hodge test for carbapenemase of different genotypes in Enterobacteriaceae,and to analyze the minimum inhibitory concentration(MIC) of carbapenem-resistant Enterobacteriaceae(CRE) on common clinical medicines,so as to aid the clinician to choose reasonable medicines. Methods:Forty CRE strains isolated from clinical specimens in our hospital from June 2018 to December 2018 were collected. VITEK 2 Compact automatic bacterial identification/drug sensitivity system was used to conduct the identification and drug sensitivity;E-test method was used to detect the imipenem,meropenem,tegacycline,amikacin,levofloxacin and compound sulfamethoxazole on MICs of CRE;broth microdilution method was used to detect the MIC of polymyxin. The mCIM/eCIM test and modified Hodge test were used to detect the situation of CRE to produce carbapen-emase. PCR was used to detect carbapenem resistance genes(blaKPC,blaNDM,blaIMP,blaVIM and blaOXA-48),extended-spectrum β-lactamase genes(SHV,TEM,CTX andOXA-1),AmpC enzyme-encod-ing genes(FOX),and membrane pore proteins ompK35 and ompK36 genes. Results:Among 40 CREs,38 strains carried the carbapen-emase gene,including blaKPC of 35 strains,blaNDM of 7 strains,blaKPC+blaNDM of 4 strains. Positive rates of the modified Hodge test,mCIM/eCIM test to KPC carbapenemase were 100%(38/38). Positive rates of mCIM/eCIM test to NDM carbapenemase were 100%(3/3). Positive rates of the modified Hodge test to NDM carbapenemase were 0. Drug resistance analysis:drug-resistance rates of 40 CRE strains to common clinical antibiotics,such as the third and the fourth generation of cephalosporins,enzyme inhibitor mix-ture,aztreonam,imipenem and meropenem,were all 100%;those to levofloxacin,amikacin and compound neotamin were 90.0%,60.0% and 42.5%,respectively. It is not found that strains were resistant to tigecycline and polymyxin. Conclusion:Both mCIM/eCIM test and modified Hodge test have high sensitivity to KPC carbapenemase,but mCIM/eCIM test is more sensitive than modified Hodge test to NDM carbapenemase,suggesting to select suitable antibiotics for CRE to different drug resistance phenotypes.