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Rapid Detection and Differentiation of KPC and MBL Carbapenemases among Enterobacterales Isolates by a Modified Combined-Disk Test

MING WEI
MING WEI
, 
PENG WANG
PENG WANG
, 
SHUAI WANG
SHUAI WANG
, 
CHUNXIA YANG
CHUNXIA YANG
 et 
LI GU
LI GU
   | 17 sept. 2021
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Article Category: original-paper
Publié en ligne: 17 sept. 2021
Pages: 387 - 394
Reçu: 13 mai 2021
Accepté: 28 juil. 2021
DOI: https://doi.org/10.33073/pjm-2021-036
Mots clés
© 2021 Ming Wei et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1.

The inhibitory zone diameter distribution of a) imipenem, b) meropenem for Enterobacterales isolates tested.
The inhibitory zone diameter distribution of a) imipenem, b) meropenem for Enterobacterales isolates tested.

Fig. 2.

Flow diagram of the mCDT for distinguishing CRE from CSE isolates, and differentiating KPC and/or MBL producers.A – imipenem disk alone, B – imipenem disk plus 5 µl EDTA, C – imipenem disk plus 10 µl APB and D – imipenem disk plus 5 µl EDTA and 10 µl APB.
Flow diagram of the mCDT for distinguishing CRE from CSE isolates, and differentiating KPC and/or MBL producers.A – imipenem disk alone, B – imipenem disk plus 5 µl EDTA, C – imipenem disk plus 10 µl APB and D – imipenem disk plus 5 µl EDTA and 10 µl APB.

Fig. 3.

Examples of mCDT showing the inhibitory zone diameters of A, B, C, and D for a) a plate 7, 7, 14, and 15 mm confirming the KPC-producing isolate, and for b) a plate 9, 17, 8, 18 mm confirming the MBL-producing isolate.A – imipenem disk alone, B – imipenem disk plus 5 µl EDTA, C – imipenem disk plus 10 µl APB and D – imipenem disk plus 5 µl EDTA and 10 µl APB.
Examples of mCDT showing the inhibitory zone diameters of A, B, C, and D for a) a plate 7, 7, 14, and 15 mm confirming the KPC-producing isolate, and for b) a plate 9, 17, 8, 18 mm confirming the MBL-producing isolate.A – imipenem disk alone, B – imipenem disk plus 5 µl EDTA, C – imipenem disk plus 10 µl APB and D – imipenem disk plus 5 µl EDTA and 10 µl APB.

Species distribution of different carbapenemase types among non-CP-CRE and 3GCeRE isolates.

Category (n)Species
KpnEcoEclKaeCfrPrePmiSma
KPC (107)104    1    0    11000
MBL (36)
NDM (30)    7  15    1    01411
IMP (6)    3    0    3    00000
OXA-48-like (1)    1    0    0    00000
KPC+NDM (1)    1    0    0    00000
Non-CP-CRE (18)    8    5    2    30000
3GCeRE (90)  17  47    7  102142
Total (253)141  68  13  144553

Accuracy of detecting KPC or MBL carbapenemases among 163 CRE isolates under different conditions.

CategoryCarbapenemaseAccuracy
Sensitivity (%), (95% CI)Specificity (%), (95% CI)
IPM-5 μ APBKPC88.8 (80.9-93.8)100 (92.0-100)
IPM-5 μ EDTAMBL100 (88.0-100)100 (96.3-100)
IPM-10 μ APBKPC97.2 (91.4-99.3)100 (92.0-100)
IPM-10 μ EDTAMBL100 (88.0-100)100 (96.3-100)
MEM-5 μ APBKPC48.6 (38.9-58.4)100 (92.0-100)
MEM-5 μ EDTAMBL100 (88.0-100)100 (96.3-100)
MEM-10 μ APBKPC59.8 (49.9-69.0)100 (92.0-100)
MEM-10 μ EDTAMBL100 (88.0-100)100 (96.3-100)
eISSN:
2544-4646
Langue:
Anglais
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Sujets de la revue:
Life Sciences, Microbiology and Virology
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