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Evaluation of the Hodge Test and the Imipenem-EDTA Double-Disk Synergy Test for Differentiating Metallo-β-Lactamase-Producing Isolates of Pseudomonas spp. and Acinetobacter spp.

 K. Lee  ;  Y. S. Lim  ;  Y. Chong  ;  J. H. Yum  ;  D. Yong 
 Journal of Clinical Microbiology, Vol.41(10) : 4623-4629, 2003 
Journal Title
 Journal of Clinical Microbiology 
Issue Date
Acinetobacter/drug effects ; Acinetobacter/enzymology* ; Anti-Bacterial Agents/pharmacology ; Ceftazidime/pharmacology ; Drug Resistance, Bacterial ; Edetic Acid/pharmacology ; Humans ; Imipenem/pharmacology ; Microbial Sensitivity Tests/methods ; Pseudomonas/drug effects ; Pseudomonas/enzymology* ; beta-Lactamases/metabolism*
Gram-negative bacilli with acquired metallo-β-lactamase (MBL) production have been increasingly reported in some countries, necessitating their detection. The aim of this study was to evaluate the performance of the Hodge test and those of the imipenem (IPM)-EDTA, ceftazidime (CAZ)-mercaptopropionic acid (MPA), and CAZ-sodium mercaptoacetic acid (SMA) double-disk synergy tests (DDSTs). The efficiencies of testing CAZ-resistant and IPM-nonsusceptible isolates were also compared. Strains used for the evaluation were known IMP-1 and VIM-2 MBL-producing isolates and consecutive and CAZ-nonsusceptible isolates of pseudomonads and acinetobacters. The performance of the Hodge test was improved by addition of zinc sulfate (140 μg/disk) to an IPM disk. In DDSTs, EDTA (ca. 1,900 μg) disks were better at detecting MBL-producing strains among pseudomonads, while MPA (3 μl) and SMA (3 mg) disks performed better for acinetobacters. EDTA (ca. 750 μg)-plus-SMA (ca. 2 mg) disks performed better than EDTA, MPA, or SMA disks with both organisms. CAZ-SMA DDSTs failed to detect 22 of 80 (28%) MBL-producing acinetobacters. In conclusion, use of an IPM disk and an EDTA (750 μg)-plus-SMA (2 mg) disk improves performance, and testing IPM-nonsusceptible isolates rather than CAZ-resistant isolates could reduce screening work. Further evaluation of the test is required for the detection of other types of MBL-producing gram-negative bacilli.
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1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
5. Research Institutes (연구소) > Research Institute of Bacterial Resistance (세균내성연구소) > 1. Journal Papers
Yonsei Authors
Yum, Jong Hwa(염종화)
Yong, Dong Eun(용동은) ORCID logo https://orcid.org/0000-0002-1225-8477
Lee, Kyungwon(이경원) ORCID logo https://orcid.org/0000-0003-3788-2134
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