Abstract:
OBJECTIVE To compare the capability of modified Hodge test, modified carbapenem inactivation method (mCIM) and Carba NP test for rapid screening of phenotypes of carbapenemase-producing
Klebsiella pneumoniae.
METHODS PCR was used to amplify the carbapenemase-related genes in the
K.pneumoniae and taken as the golden standard, and the capability of the modified Hodge test, Carba NP test and mCIM test in screening of 202 strains of carbapenemase-producing
K.pneumoniae test isolates was observed and compared.
RESULTS Of the 202 test strains, 120 were PCR amplified positive for the drug resistance genes, the result of sequencing of amplified products showed that 75 strains only carried
blaKPC gene,20 strains simultaneously carried
blaKPC and
blaVIM genes,19 strains simultaneously carried
blaKPC and
blaIMP genes,3 strains only carried
blaIMP gene,2 strains only carried
blaVIM gene, and 1 strain only carried
blaNDM-1 gene.The drug resistance rates of the 120 strains of carbapenemase-producing
K.pneumoniae isolates to imipenem, ertapenem and cephalosporins were 100%, while the strains were sensitive to tigecycline and polymyxin B.The 82 strains of non- carbapenemase-producing control isolates were sensitive to imipenem and ertapenem, while the drug resistance rate to ceftriaxone was 100%.Taken the PCR result as the golden standard, the sensitivities of the modified Hodge test, Carba NP test and mCIM test in screening of the test strains were 92.5%, 94.17% and 98.33%, respectively; the specificities were 97.56%, 98.78% and 100%, respectively.As compared with the PCR results, the consistency rate of the modified Hodge test was 94.55%, with the Kappa value 0.8885; the consistency rate of the Carba NP test was 96.04%, with Kappa value 0.9188; the consistency rate of the mCIM test was 99.01%, with Kappa value 0.9796.
CONCLUSION The sensitivity and specificity of the Carba NP test and mCIM test are higher than those of the modified Hodge test in rapid detection of carbapenemase-producing
K.pneumoniae, and the operation procedures are so simple that they are worthy to be promoted in clinical microorganism laboratory, infection control rooms and departments of disease prevention and control.