Detection of carbapenemases in Enterobacterales susceptible in vitro to meropenem

Luana Silva Dornelles , Mariana Preussler Mott , Gabriela da Silva Collar , Luciana Giordani , Rodrigo Minuto Paiva , Larissa Lutz
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Abstract

Introduction

Carbapenemase-producing Enterobacterales (CPE) is a global threat. We evaluate the prevalence of CPE among isolates categorized as meropenem-susceptible, but that meet the European Committee on Antimicrobial Susceptibility Testing (EUCAST) screening cut-off values for carbapenemase detection, and analyze the susceptibility of these isolates to new available drugs.

Methods

We analyzed 257 isolates from patients hospitalized in a tertiary hospital in Brazil, from July 2022 to April 2023. Only isolates that met the screening cut-off values established by EUCAST for detection of carbapenemases were analyzed (i.e. meropenem inhibition zones of 25–27 mm by disk diffusion). The detection of carbapenemases was performed by immnunochromatographic testing and confirmed by high-resolution melting-PCR (HRM-qPCR).

Results

We identified 12 (4.7%) CPE including 7 KPC, 4 NDM, and 1 OXA-48-like. The isolates were susceptible to ceftazidime–avibactam (72.7%), meropenem–vaborbactam (100%), imipenem–relebactam (63.6%) and ceftolozane–tazobactam (36.4%).

Conclusion

We highlight the importance of tracking carbapenemases for epidemiological control and therapeutic guidance.
在体外对美罗培南敏感的肠杆菌中检测碳青霉烯酶。
产碳青霉烯酶肠杆菌(CPE)是一种全球性威胁。我们评估了被归类为美罗培尼敏感但符合欧洲抗微生物药物敏感性试验委员会(EUCAST)筛选碳青霉烯酶检测临界值的分离株中CPE的患病率,并分析了这些分离株对现有新药的敏感性。方法:对2022年7月至2023年4月在巴西某三级医院住院的257株分离株进行分析。仅分析符合EUCAST建立的碳青霉烯酶检测筛选临界值的分离株(即圆盘扩散法美罗培南抑制区为25-27mm)。碳青霉烯酶采用免疫层析检测,高分辨率熔融pcr (HRM-qPCR)检测。结果:我们鉴定了12例(4.7%)CPE,包括7例KPC, 4例NDM和1例oxa -48样。对头孢他啶-阿维巴坦(72.7%)、美罗培恩-瓦波巴坦(100%)、亚胺培南-瑞巴坦(63.6%)和头孢洛赞-他唑巴坦(36.4%)敏感。结论:我们强调追踪碳青霉烯酶对流行病学控制和治疗指导的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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