Phenotype Detection and Drug Resistance Analysis of Carbapenem-Resistant Gram-Negative Bacilli

IF 2.6 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis Pub Date : 2025-04-18 DOI:10.1002/jcla.70038

Xiao-min Liu, Ya-xian Wu, Xiao-hui Li, Jia-wen Shang, Wen-na Xu, Nan-song Xu, Qiu-yao Zeng, Xin Zheng

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Abstract

Background

The increasing prevalence of infections caused by carbapenem-resistant organisms (CRO) represents a global health issue. Therefore, a rapid and accurate method for detecting these microbes in any clinical microbiology laboratory is crucial for the prevention and control of their transmission, as well as for clinical treatment. This study aimed to evaluate the phenotypic detection methods, PBA-EDTA, mCIM, PCR, and immunocolloidal gold kit for CRO.

Methods

We collected 99 samples from the inpatients in Sun Yat-Sen University Cancer Center (SYSUCC) from March 2019 to February 2022 and classified the drug resistance and genotype of various strains by various enzyme-type experiments.

Results

Out of 99 multidrug-resistant Gram-negative bacilli resistant to carbapenems, 58 (58.59%) were identified as carbapenemase-positive using the mCIM test. The carbapenemase genotypes included 19 NDM strains, 4 KPC strains, 1 IMP strain, and 5 OXA-23 strains. Enzyme detection revealed 21 strains positive for metallo-β-lactamase, 50 for serine-β-lactamase, and 2 positive for both, with a total positive rate of 73.74%. 26 strains were negative for enzyme detection, and mCIM showed limited effectiveness in detecting strains coproducing NDM and KPC. The immunocolloidal gold assay had a sensitivity of 96.9% and specificity of 98.5%.

Conclusion

This study used an immunocolloidal gold kit for carbapenemase detection, providing results within 15 min. This cost-effective method can quickly assist in identifying carbapenemase genotypes and holds potential as a new rapid detection and diagnostic tool for CRE in clinical and lab settings.

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耐碳青霉烯革兰氏阴性杆菌表型检测及耐药性分析

碳青霉烯耐药菌（CRO）引起的感染日益流行，这是一个全球性的健康问题。因此，在任何临床微生物实验室中，快速准确地检测这些微生物的方法对于预防和控制其传播以及临床治疗至关重要。本研究旨在评估表型检测方法，PBA-EDTA, mCIM， PCR和免疫胶体金试剂盒检测CRO。方法采集2019年3月至2022年2月中山大学肿瘤中心住院患者99例样品，通过各种酶型实验对不同菌株的耐药性和基因型进行分类。结果99株耐碳青霉烯类多重耐药革兰氏阴性杆菌中，mCIM检测碳青霉烯酶阳性58株（58.59%）。碳青霉烯酶基因型包括19株NDM、4株KPC、1株IMP和5株OXA-23。酶检结果显示金属β-内酰胺酶阳性21株，丝氨酸-β-内酰胺酶阳性50株，两种酶均阳性2株，总阳性率为73.74%。26株酶检测阴性，mCIM检测NDM和KPC共产菌株的效果有限。免疫胶体金法的灵敏度为96.9%，特异性为98.5%。结论本研究采用免疫胶体金试剂盒检测碳青霉烯酶，可在15 min内得到结果。这种具有成本效益的方法可以快速帮助鉴定碳青霉烯酶基因型，并有潜力作为临床和实验室环境中CRE的新的快速检测和诊断工具。

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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来源期刊

Journal of Clinical Laboratory Analysis 医学-医学实验技术

CiteScore

5.60

自引率

7.40%

发文量

584

审稿时长

6-12 weeks

期刊介绍： Journal of Clinical Laboratory Analysis publishes original articles on newly developing modes of technology and laboratory assays, with emphasis on their application in current and future clinical laboratory testing. This includes reports from the following fields: immunochemistry and toxicology, hematology and hematopathology, immunopathology, molecular diagnostics, microbiology, genetic testing, immunohematology, and clinical chemistry.