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Title: Carbapenemase-producing carbapenem-resistant enterobacteriaceae from Bangkok, Thailand, and their detection by the Carba NP and modified carbapenem inactivation method tests
Authors: Warawut Laolerd
Yukihiro Akeda
Likit Preeyanon
Panan Ratthawongjirakul
Pitak Santanirand
Chulalongkorn University
Osaka University
Handai Byoin
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Osaka University Faculty of Medicine
Mahidol University
Keywords: Immunology and Microbiology;Medicine;Pharmacology, Toxicology and Pharmaceutics
Issue Date: 1-Sep-2018
Citation: Microbial Drug Resistance. Vol.24, No.7 (2018), 1006-1011
Abstract: © 2018 Mary Ann Liebert, Inc. Aim: The purpose of the study was to determine the epidemiology of carbapenemase genes among carbapenem-resistant Enterobacteriaceae and evaluate the Carba NP and modified carbapenem inactivation method (mCIM) tests in their detection. Materials and Methods: A total of 287 nonduplicated Enterobacteriaceae isolates, which were at least resistant to one of the carbapenems, were identified and detected for carbapenemase genes by multiplex PCR covering bla KPC , bla NDM , bla VIM , bla IMP , and bla OXA-48-like . All positive genes were then sequenced. These isolates were phenotypically tested for the production of carbapenemases by mCIM and Carba NP tests to evaluate the efficacy of these methods. Results: Seven species of carbapenem-resistant isolates mainly Klebsiella pneumoniae, Escherichia coli, and Enterobacter cloacae were detected. Of these isolates, three families of carbapenemase genes, including bla NDM (bla NDM-1 , -4 , -5 , -9 ), bla OXA (bla OXA-48 , -181 , -232 ), and bla IMP-14 , were found. Of these, 223 (77.70%) carried at least one of the carbapenemase genes. The bla NDM was detected in 160/223 (71.75%) isolates, of which 153/160 (95.63%) were the bla NDM-1 . Three types of the bla OXA-48-like group, bla OXA-48 , bla OXA-181 , and bla OXA-232 , were found, 91/104 (87.5%) harbored the bla OXA-232 . In addition, 25.11% (56/223) of the carbapenemase-producing isolates harbored a combination of bla NDM and bla OXA-48-like . Phenotypic detection methods, mCIM and Carba NP, showed 100% sensitivity and specificity to bla NDM , bla IMP-14 , and bla OXA-48 , while the mCIM was positive in all bla OXA-181 and bla OXA-232 isolates, only 12.5% (1/8) and 28.95% (11/38), respectively, were detected by the Carba NP test. Conclusions: This study revealed a unique prevalence of carbapenemase genes in Bangkok, Thailand, as well as demonstrated the efficacy and limitation of phenotypic detection methods of carbapenemase in the area where bla NDM-1 and bla OXA-232 were predominant.
ISSN: 19318448
Appears in Collections:Scopus 2018

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