Jinghao Zhang, Jieli Xu, Siquan Shen, Li Ding, Weiwei Yang, Chengkang Tang, Qingyu Shi, Hu Zhao, Yan Guo, Renru Han, Fupin Hu
{"title":"三种胶体金免疫测定和 GeneXpert Carba-R 检测肺炎克雷伯氏菌 blaKPC-2 变体的比较。","authors":"Jinghao Zhang, Jieli Xu, Siquan Shen, Li Ding, Weiwei Yang, Chengkang Tang, Qingyu Shi, Hu Zhao, Yan Guo, Renru Han, Fupin Hu","doi":"10.1128/jcm.00154-24","DOIUrl":null,"url":null,"abstract":"<p><p>The increasing use of ceftazidime-avibactam has led to the emergence of a wide range of ceftazidime-avibactam-resistant <i>bla</i><sub>KPC-2</sub> variants. Particularly, the conventional carbapenemase phenotypic assay exhibited a high false-negative rate for KPC-2 variants. In this study, three colloidal gold immunoassays, including the Gold Mountainriver CGI test, Dynamiker CGI test and NG-Test CARBA5, and GeneXpert Carba-R, were used to detect the presence of KPC-2 carbapenemase and its various variants in 42 <i>Klebsiella pneumoniae</i> strains. These strains covered <i>bla</i><sub>KPC-2</sub> (13/42) and 16 other <i>bla</i><sub>KPC-2</sub> variants including <i>bla</i><sub>KPC-12</sub> (1/42), <i>bla</i><sub>KPC-23</sub> (1/42), <i>bla</i><sub>KPC-25</sub> (1/42), <i>bla</i><sub>KPC-33</sub> (6/42), <i>bla</i><sub>KPC-35</sub> (1/42), <i>bla</i><sub>KPC-44</sub> (1/42), <i>bla</i><sub>KPC-71</sub> (1/42), <i>bla</i><sub>KPC-76</sub> (8/42), <i>bla</i><sub>KPC-78</sub> (1/42), <i>bla</i><sub>KPC-79</sub> (1/42), <i>bla</i><sub>KPC-100</sub> (1/42), <i>bla</i><sub>KPC-127</sub> (1/42), <i>bla</i><sub>KPC-128</sub> (1/42), <i>bla</i><sub>KPC-144</sub> (1/42), <i>bla</i><sub>KPC-157</sub> (2/42), and <i>bla</i><sub>KPC-180</sub> (1/42). For KPC-2 strains, all four assays showed 100% negative percentage agreement (NPA) and 100% positive percentage agreement (PPA) with sequencing results. For all 16 KPC-2 variants, GeneXpert Carba-R showed 100% NPA and 100% PPA, and the three colloidal gold immunoassays showed 100% NPA, while the PPAs of the Gold Mountainriver CGI test, Dynamiker CGI test, and NG-Test CARBA5 were 87.5%, 87.5%, and 68.8%, respectively. We also found a correlation between the mutation site in the amino acid of the variants and false-negative results by colloidal gold immunoassays. In conclusion, the GeneXpert Carba-R has been proven to be a reliable method in detecting KPC-2 and its variants, and the colloidal gold immunoassay tests offer a practical and cost-effective approach for their detection. For the sample with a negative result by a colloidal gold immunoassay test but not matching the drug-resistant phenotype, it is recommended to retest using another type of kit or the GeneXpert Carba-R assay, which can significantly improve the accuracy of detection.</p>","PeriodicalId":15511,"journal":{"name":"Journal of Clinical Microbiology","volume":" ","pages":"e0015424"},"PeriodicalIF":6.1000,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11250111/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparison of three colloidal gold immunoassays and GeneXpert Carba-R for the detection of <i>Klebsiella pneumoniae bla</i><sub>KPC-2</sub> variants.\",\"authors\":\"Jinghao Zhang, Jieli Xu, Siquan Shen, Li Ding, Weiwei Yang, Chengkang Tang, Qingyu Shi, Hu Zhao, Yan Guo, Renru Han, Fupin Hu\",\"doi\":\"10.1128/jcm.00154-24\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The increasing use of ceftazidime-avibactam has led to the emergence of a wide range of ceftazidime-avibactam-resistant <i>bla</i><sub>KPC-2</sub> variants. Particularly, the conventional carbapenemase phenotypic assay exhibited a high false-negative rate for KPC-2 variants. In this study, three colloidal gold immunoassays, including the Gold Mountainriver CGI test, Dynamiker CGI test and NG-Test CARBA5, and GeneXpert Carba-R, were used to detect the presence of KPC-2 carbapenemase and its various variants in 42 <i>Klebsiella pneumoniae</i> strains. These strains covered <i>bla</i><sub>KPC-2</sub> (13/42) and 16 other <i>bla</i><sub>KPC-2</sub> variants including <i>bla</i><sub>KPC-12</sub> (1/42), <i>bla</i><sub>KPC-23</sub> (1/42), <i>bla</i><sub>KPC-25</sub> (1/42), <i>bla</i><sub>KPC-33</sub> (6/42), <i>bla</i><sub>KPC-35</sub> (1/42), <i>bla</i><sub>KPC-44</sub> (1/42), <i>bla</i><sub>KPC-71</sub> (1/42), <i>bla</i><sub>KPC-76</sub> (8/42), <i>bla</i><sub>KPC-78</sub> (1/42), <i>bla</i><sub>KPC-79</sub> (1/42), <i>bla</i><sub>KPC-100</sub> (1/42), <i>bla</i><sub>KPC-127</sub> (1/42), <i>bla</i><sub>KPC-128</sub> (1/42), <i>bla</i><sub>KPC-144</sub> (1/42), <i>bla</i><sub>KPC-157</sub> (2/42), and <i>bla</i><sub>KPC-180</sub> (1/42). For KPC-2 strains, all four assays showed 100% negative percentage agreement (NPA) and 100% positive percentage agreement (PPA) with sequencing results. For all 16 KPC-2 variants, GeneXpert Carba-R showed 100% NPA and 100% PPA, and the three colloidal gold immunoassays showed 100% NPA, while the PPAs of the Gold Mountainriver CGI test, Dynamiker CGI test, and NG-Test CARBA5 were 87.5%, 87.5%, and 68.8%, respectively. We also found a correlation between the mutation site in the amino acid of the variants and false-negative results by colloidal gold immunoassays. In conclusion, the GeneXpert Carba-R has been proven to be a reliable method in detecting KPC-2 and its variants, and the colloidal gold immunoassay tests offer a practical and cost-effective approach for their detection. For the sample with a negative result by a colloidal gold immunoassay test but not matching the drug-resistant phenotype, it is recommended to retest using another type of kit or the GeneXpert Carba-R assay, which can significantly improve the accuracy of detection.</p>\",\"PeriodicalId\":15511,\"journal\":{\"name\":\"Journal of Clinical Microbiology\",\"volume\":\" \",\"pages\":\"e0015424\"},\"PeriodicalIF\":6.1000,\"publicationDate\":\"2024-07-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11250111/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Microbiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1128/jcm.00154-24\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/5/29 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"MICROBIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Microbiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1128/jcm.00154-24","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/29 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"MICROBIOLOGY","Score":null,"Total":0}
Comparison of three colloidal gold immunoassays and GeneXpert Carba-R for the detection of Klebsiella pneumoniae blaKPC-2 variants.
The increasing use of ceftazidime-avibactam has led to the emergence of a wide range of ceftazidime-avibactam-resistant blaKPC-2 variants. Particularly, the conventional carbapenemase phenotypic assay exhibited a high false-negative rate for KPC-2 variants. In this study, three colloidal gold immunoassays, including the Gold Mountainriver CGI test, Dynamiker CGI test and NG-Test CARBA5, and GeneXpert Carba-R, were used to detect the presence of KPC-2 carbapenemase and its various variants in 42 Klebsiella pneumoniae strains. These strains covered blaKPC-2 (13/42) and 16 other blaKPC-2 variants including blaKPC-12 (1/42), blaKPC-23 (1/42), blaKPC-25 (1/42), blaKPC-33 (6/42), blaKPC-35 (1/42), blaKPC-44 (1/42), blaKPC-71 (1/42), blaKPC-76 (8/42), blaKPC-78 (1/42), blaKPC-79 (1/42), blaKPC-100 (1/42), blaKPC-127 (1/42), blaKPC-128 (1/42), blaKPC-144 (1/42), blaKPC-157 (2/42), and blaKPC-180 (1/42). For KPC-2 strains, all four assays showed 100% negative percentage agreement (NPA) and 100% positive percentage agreement (PPA) with sequencing results. For all 16 KPC-2 variants, GeneXpert Carba-R showed 100% NPA and 100% PPA, and the three colloidal gold immunoassays showed 100% NPA, while the PPAs of the Gold Mountainriver CGI test, Dynamiker CGI test, and NG-Test CARBA5 were 87.5%, 87.5%, and 68.8%, respectively. We also found a correlation between the mutation site in the amino acid of the variants and false-negative results by colloidal gold immunoassays. In conclusion, the GeneXpert Carba-R has been proven to be a reliable method in detecting KPC-2 and its variants, and the colloidal gold immunoassay tests offer a practical and cost-effective approach for their detection. For the sample with a negative result by a colloidal gold immunoassay test but not matching the drug-resistant phenotype, it is recommended to retest using another type of kit or the GeneXpert Carba-R assay, which can significantly improve the accuracy of detection.
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The Journal of Clinical Microbiology® disseminates the latest research concerning the laboratory diagnosis of human and animal infections, along with the laboratory's role in epidemiology and the management of infectious diseases.
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