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Evaluation of double-disk potentiation and disk potentiation tests using dipicolinic acid for detection of metallo-β-lactamase-producing pseudomonas spp. and Acinetobacter spp

Authors
 Dongeun Yong  ;  Yangsoon Lee  ;  Seok Hoon Jeong  ;  Kyungwon Lee  ;  Yunsop Chong 
Citation
 JOURNAL OF CLINICAL MICROBIOLOGY, Vol.50(10) : 3227-3232, 2012 
Journal Title
 JOURNAL OF CLINICAL MICROBIOLOGY 
ISSN
 0095-1137 
Issue Date
2012
MeSH
Acinetobacter/enzymology* ; Acinetobacter/isolation & purification ; Acinetobacter Infections/microbiology ; Bacteriological Techniques/methods* ; Culture Media/chemistry ; Humans ; Picolinic Acids/metabolism ; Pseudomonas/enzymology* ; Pseudomonas/isolation & purification ; Pseudomonas Infections/microbiology ; Sensitivity and Specificity ; beta-Lactamases/analysis*
Keywords
Acinetobacter/enzymology* ; Acinetobacter/isolation & purification ; Acinetobacter Infections/microbiology ; Bacteriological Techniques/methods* ; Culture Media/chemistry ; Humans ; Picolinic Acids/metabolism ; Pseudomonas/enzymology* ; Pseudomonas/isolation & purification ; Pseudomonas Infections/microbiology ; Sensitivity and Specificity ; beta-Lactamases/analysis*
Abstract
Accurate detection of metallo-β-lactamase (MBL)-producing Pseudomonas spp. and Acinetobacter spp. became very important with the increasing prevalence of carbapenem-nonsusceptible clinical isolates. The performance of phenotypic MBL detection methods may depend on the types of MBL and the characteristics of the isolates. A high false-positive rate is a problem with EDTA-based MBL detection methods. We evaluated the performance of double-disk potentiation tests (DDPTs) and disk potentiation tests (DPTs) with dipicolinic acid (DPA) using 44 isolates of Pseudomonas spp. and Acinetobacter spp. producing IMP-1-like, VIM-2-like, and SIM-1 type MBLs. Also, we characterized P. aeruginosa isolates with positive imipenem (IPM)-DPA DDPT, but negative meropenem (MEM)-DPA DDPT, and determined possibility of improving a DDPT by using MacConkey agar. Among five different DDPT methods, the IPM-DPA 250-μg method showed the highest sensitivity (97.7%) and specificity (100%). Among four DPT tests, the highest sensitivity (100%) was shown by the IPM-EDTA 1,900-μg disk method, but the specificity was very low (11.4%). Five of six P. aeruginosa isolates with false-negative DDPTs with MEM-DPA 250-μg disks carried bla(IMP-6,) and the high level resistance to MEM (MIC ≥ 512 μg/ml) was reduced by the presence of phenylalanine arginine β-naphtylamide. Improvement of DDPTs was observed when MacConkey agar was used instead of Mueller-Hinton agar. In conclusion, DPA is a better MBL inhibitor than EDTA for detection of Pseudomonas spp. and Acinetobacter spp. with IMP-1-like, VIM-2-like, and SIM-1-type MBLs. In DPA DDPTs, IPM disks perform better than MEM disks when the isolates are highly resistant to MEM due to the overexpression of efflux pumps.
Files in This Item:
T201203227.pdf Download
DOI
22837321
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
Lee, Kyungwon(이경원) ORCID logo https://orcid.org/0000-0003-3788-2134
Lee, Yang Soon(이양순)
Jeong, Seok Hoon(정석훈) ORCID logo https://orcid.org/0000-0001-9290-897X
Chong, Yun Sop(정윤섭)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90694
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