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Combined use of the modified Hodge test and carbapenemase inhibition test for detection of carbapenemase-producing Enterobacteriaceae and metallo-β-lactamase-producing Pseudomonas spp

Authors
 Wonkeun Song  ;  Seong Geun Hong  ;  Dongeun Yong  ;  Seok Hoon Jeong  ;  Hyun Soo Kim  ;  Han-Sung Kim  ;  Jae-Seok Kim  ;  Il Kwon Bae 
Citation
 ANNALS OF LABORATORY MEDICINE, Vol.35(2) : 212-219, 2015 
Journal Title
 ANNALS OF LABORATORY MEDICINE 
ISSN
 2234-3806 
Issue Date
2015
MeSH
Bacterial Proteins/antagonists & inhibitors ; Bacterial Proteins/metabolism* ; Boronic Acids/chemistry ; Boronic Acids/pharmacology ; Disk Diffusion Antimicrobial Tests/methods* ; Edetic Acid/chemistry ; Edetic Acid/pharmacology ; Enterobacteriaceae/drug effects ; Enterobacteriaceae/enzymology* ; Enterobacteriaceae Infections/diagnosis ; Humans ; Pseudomonas/drug effects ; Pseudomonas/enzymology* ; Pseudomonas Infections/diagnosis ; Sensitivity and Specificity ; beta-Lactamases/chemistry ; beta-Lactamases/metabolism*
Keywords
Carbapenemase inhibition test ; EDTA ; Enterobacteriaceae ; Modified Hodge test ; Phenylboronic acid ; Pseudomonas spp.
Abstract
BACKGROUND: We evaluated the combined use of the modified Hodge test (MHT) and carbapenemase inhibition test (CIT) using phenylboronic acid (PBA) and EDTA to detect carbapenemase-producing Enterobacteriaceae (CPE) and metallo-β-lactamase (MBL)-producing Pseudomonas spp. METHODS: A total of 49 isolates of CPE (15 Klebsiella pneumoniae carbapenemase [KPC], 5 Guiana extended-spectrum β-lactamase [GES]-5, 9 New Delhi metallo-β-lactamase [NDM]-1, 5 Verona integron-encoded metallo-β-lactamase [VIM]-2, 3 imipenem-hydrolyzing β-lactamase [IMP], and 12 oxacillinase [OXA]-48-like), 25 isolates of MBL-producing Pseudomonas spp. (14 VIM-2 and 11 IMP), and 35 carbapenemase-negative controls were included. The MHT was performed for all isolates as recommended by the Clinical and Laboratory Standards Institute. Enhanced growth of the indicator strain was measured in mm with a ruler. The CIT was performed by directly dripping PBA and EDTA solutions onto carbapenem disks that were placed on Mueller-Hinton agar plates seeded with the test strain. RESULTS: Considering the results of the MHT with the ertapenem disk in Enterobacteriaceae and Pseudomonas spp., the CIT with the meropenem disk in Enterobacteriaceae, and the imipenem disk in Pseudomonas spp., three combined disk tests, namely MHT-positive plus PBA-positive, EDTA-positive, and MHT-positive plus PBA-negative plus EDTA-negative, had excellent sensitivity and specificity for the detection of KPC- (100% sensitivity and 100% specificity), MBL- (94% sensitivity and 100% specificity), and OXA-48-like-producing isolates (100% sensitivity and 100% specificity), respectively. CONCLUSIONS: Combined use of the MHT and CIT with PBA and EDTA, for the detection of CPE and MBL-producing Pseudomonas spp., is effective in detecting and characterizing carbapenemases in routine laboratories.
Files in This Item:
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DOI
10.3343/alm.2015.35.2.212
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Yong, Dong Eun(용동은) ORCID logo https://orcid.org/0000-0002-1225-8477
Jeong, Seok Hoon(정석훈) ORCID logo https://orcid.org/0000-0001-9290-897X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139468
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