Evaluation of the commercial combined disk test and minimum inhibitory concentration (MIC) determination for detection of carbapenemase producers among Gram-negative bacilli isolated in a region with high prevalence of bla                          OXA-48                          and bla                          NDM

Zoya Hojabri; Maedeh Arab; Narges Darabi; Naim Sadat Kia; Bruno S. Lopes; Omid Pajand

doi:10.1007/s10123-018-0030-1

Evaluation of the commercial combined disk test and minimum inhibitory concentration (MIC) determination for detection of carbapenemase producers among Gram-negative bacilli isolated in a region with high prevalence of bla _OXA-48 and bla _NDM

Zoya Hojabri, Maedeh Arab, Narges Darabi, Naim Sadat Kia, Bruno S. Lopes, Omid Pajand

SHLS Life Sciences

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

Abstract

Carbapenem-resistant Gram-negative bacilli (GNB) are a concern in the Middle East and worldwide. Simple screening methods have been sought to detect carbapenemase producers to determine appropriate therapeutic measures and implement infection control interventions. In this study, we evaluated the efficiency of agar disc diffusion, commercial combined disc test (Rosco), and carbapenem MIC determination in comparison to molecular detection of carbapenemase genes among 82 carbapenem non-susceptible Enterobacteriaceae (CNSE) and 37 Acinetobacter/Pseudomonas isolates. The bla _OXA-48 , bla _NDM , bla _NDM/OXA-48 , and bla _IMP were detected in 68 out of 82 CNSE isolates. All of the Acinetobacter baumannii isolates were positive for the bla _OXA-51 (n = 23), of those some were positive for bla _OXA-48 (n = 13) and bla _NDM (n = 3). Sensitivities and specificities of combined disc test for detection of bla _NDM and bla _OXA-48 carrying Enterobacteriaceae isolates were 92.5% and 100%, and 58.5% and 100%, respectively, while those for Acinetobacter/Pseudomonas isolates were 100%, 81.8% and 96.2%, 89%, respectively. While carbapenem MIC values had excellent concordance with phenotypic combined disc test for detection of bla _OXA-48 producers (area under curve > 90%), only ertapenem MIC’s could precisely detect bla _OXA-48 PCR-positive Enterobacteriaceae isolates (AUC 70%, sensitivity 70%, specificity 50%). The phenotypic commercial test showed excellent sensitivity for detection of bla _NDM producers, but had poor sensitivity for bla _OXA-48 -producing Enterobacteriaceae. Ertapenem MIC values had low sensitivity and specificity for detection of the bla _OXA-48 -carrying Enterobacteriaceae. This is the first report of A. baumannii isolates co-harbored the bla _OXA-48 /bla _NDM carbapenemases from Iran.

Original language	English
Pages (from-to)	81-89
Number of pages	9
Journal	International Microbiology
Volume	22
Issue number	1
Early online date	30 Aug 2018
DOIs	https://doi.org/10.1007/s10123-018-0030-1
Publication status	Published - 13 Mar 2019

Bibliographical note

Funding Information:
Funding This work was supported fully by Semnan University of Medical Sciences (grant nos.730 and 919). This is a report of a database from research projects entitled BInvestigation of the prevalence, antimicrobial susceptibility testing and carbapenemase production among Enterobacteriaceae and Pseudomonas aeruginosa isolates recovered from clinical specimens collected from Semnan hospitals and the effect of driving factors^ and BDetermination of Minimum Inhibitory Concentration (MIC) of Ertapenem in carbapenem non-susceptible isolates of Enterobacteriaceae recovered from hospitalized patients^ registered in Semnan University of Medical Sciences, Semnan, Iran.

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© 2018, Springer Nature Switzerland AG.

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Hojabri, Z., Arab, M., Darabi, N., Kia, N. S., Lopes, B. S., & Pajand, O. (2019). Evaluation of the commercial combined disk test and minimum inhibitory concentration (MIC) determination for detection of carbapenemase producers among Gram-negative bacilli isolated in a region with high prevalence of bla _OXA-48 and bla _NDM. International Microbiology, 22(1), 81-89. https://doi.org/10.1007/s10123-018-0030-1

Hojabri, Zoya ; Arab, Maedeh ; Darabi, Narges et al. / Evaluation of the commercial combined disk test and minimum inhibitory concentration (MIC) determination for detection of carbapenemase producers among Gram-negative bacilli isolated in a region with high prevalence of bla _OXA-48 and bla _NDM. In: International Microbiology. 2019 ; Vol. 22, No. 1. pp. 81-89.

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title = "Evaluation of the commercial combined disk test and minimum inhibitory concentration (MIC) determination for detection of carbapenemase producers among Gram-negative bacilli isolated in a region with high prevalence of bla OXA-48 and bla NDM",

abstract = " Carbapenem-resistant Gram-negative bacilli (GNB) are a concern in the Middle East and worldwide. Simple screening methods have been sought to detect carbapenemase producers to determine appropriate therapeutic measures and implement infection control interventions. In this study, we evaluated the efficiency of agar disc diffusion, commercial combined disc test (Rosco), and carbapenem MIC determination in comparison to molecular detection of carbapenemase genes among 82 carbapenem non-susceptible Enterobacteriaceae (CNSE) and 37 Acinetobacter/Pseudomonas isolates. The bla OXA-48 , bla NDM , bla NDM/OXA-48 , and bla IMP were detected in 68 out of 82 CNSE isolates. All of the Acinetobacter baumannii isolates were positive for the bla OXA-51 (n = 23), of those some were positive for bla OXA-48 (n = 13) and bla NDM (n = 3). Sensitivities and specificities of combined disc test for detection of bla NDM and bla OXA-48 carrying Enterobacteriaceae isolates were 92.5% and 100%, and 58.5% and 100%, respectively, while those for Acinetobacter/Pseudomonas isolates were 100%, 81.8% and 96.2%, 89%, respectively. While carbapenem MIC values had excellent concordance with phenotypic combined disc test for detection of bla OXA-48 producers (area under curve > 90%), only ertapenem MIC{\textquoteright}s could precisely detect bla OXA-48 PCR-positive Enterobacteriaceae isolates (AUC 70%, sensitivity 70%, specificity 50%). The phenotypic commercial test showed excellent sensitivity for detection of bla NDM producers, but had poor sensitivity for bla OXA-48 -producing Enterobacteriaceae. Ertapenem MIC values had low sensitivity and specificity for detection of the bla OXA-48 -carrying Enterobacteriaceae. This is the first report of A. baumannii isolates co-harbored the bla OXA-48 /bla NDM carbapenemases from Iran.",

author = "Zoya Hojabri and Maedeh Arab and Narges Darabi and Kia, {Naim Sadat} and Lopes, {Bruno S.} and Omid Pajand",

note = "Funding Information: Funding This work was supported fully by Semnan University of Medical Sciences (grant nos.730 and 919). This is a report of a database from research projects entitled BInvestigation of the prevalence, antimicrobial susceptibility testing and carbapenemase production among Enterobacteriaceae and Pseudomonas aeruginosa isolates recovered from clinical specimens collected from Semnan hospitals and the effect of driving factors^ and BDetermination of Minimum Inhibitory Concentration (MIC) of Ertapenem in carbapenem non-susceptible isolates of Enterobacteriaceae recovered from hospitalized patients^ registered in Semnan University of Medical Sciences, Semnan, Iran. Publisher Copyright: {\textcopyright} 2018, Springer Nature Switzerland AG.",

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Hojabri, Z, Arab, M, Darabi, N, Kia, NS, Lopes, BS & Pajand, O 2019, 'Evaluation of the commercial combined disk test and minimum inhibitory concentration (MIC) determination for detection of carbapenemase producers among Gram-negative bacilli isolated in a region with high prevalence of bla _OXA-48 and bla _NDM', International Microbiology, vol. 22, no. 1, pp. 81-89. https://doi.org/10.1007/s10123-018-0030-1

Evaluation of the commercial combined disk test and minimum inhibitory concentration (MIC) determination for detection of carbapenemase producers among Gram-negative bacilli isolated in a region with high prevalence of bla _OXA-48 and bla _NDM. / Hojabri, Zoya; Arab, Maedeh; Darabi, Narges et al.
In: International Microbiology, Vol. 22, No. 1, 13.03.2019, p. 81-89.

Research output: Contribution to journal › Article › peer-review

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Hojabri Z, Arab M, Darabi N, Kia NS, Lopes BS, Pajand O. Evaluation of the commercial combined disk test and minimum inhibitory concentration (MIC) determination for detection of carbapenemase producers among Gram-negative bacilli isolated in a region with high prevalence of bla _OXA-48 and bla _NDM. International Microbiology. 2019 Mar 13;22(1):81-89. Epub 2018 Aug 30. doi: 10.1007/s10123-018-0030-1

Evaluation of the commercial combined disk test and minimum inhibitory concentration (MIC) determination for detection of carbapenemase producers among Gram-negative bacilli isolated in a region with high prevalence of bla OXA-48 and bla NDM