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DC Field | Value | Language |
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dc.contributor.author | Kumudunie, W.G.M. | |
dc.contributor.author | Wijesooriya, L.I. | |
dc.contributor.author | Wijayasinghe, Y.S. | |
dc.date.accessioned | 2021-02-01T03:47:32Z | |
dc.date.available | 2021-02-01T03:47:32Z | |
dc.date.issued | 2021 | |
dc.identifier.citation | PLoS One. 2021; 16(1):e0245290. | en_US |
dc.identifier.issn | 1932-6203 (Electronic) | |
dc.identifier.issn | 1932-6203 (Linking) | |
dc.identifier.uri | http://repository.kln.ac.lk/handle/123456789/21832 | |
dc.description | Indexed in MEDLINE | en_US |
dc.description.abstract | ABSTRACT: Rapidly progressing antibiotic resistance is a great challenge in therapy. In particular, the infections caused by carbapenem-resistant Enterobacteriaceae (CRE) are exceedingly difficult to treat. Carbapenemase production is the predominant mechanism of resistance in CRE. Early and accurate identification of carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE) is extremely important for the treatment and prevention of such infections. In the present study, four phenotypic carbapenemase detection tests were compared and an algorithm was developed for rapid and cost-effective identification of CP-CRE. A total of 117 Enterobacteriaceae (54 CP-CRE, 3 non-CP-CRE, and 60 non-CRE) isolates were tested for carbapenemase production using modified Hodge test (MHT), modified carbapenem inactivation method (mCIM), Carba NP test (CNPt), and CNPt-direct test. The overall sensitivity/specificity values were 90.7%/92.1% for MHT, 100%/100% for mCIM, 75.9%/100% for CNPt, and 83.3%/100% for CNPt-direct. OXA-48-like enzymes were detected with 93.2% sensitivity by MHT and >77.3% sensitivity by two Carba NP tests. MHT could only detect half of the NDM carbapenemase producers. CNPt-direct exhibited enhanced sensitivity compared to CNPt (100% vs 25%) for detection of NDM producers. Considering these findings we propose CNPt-direct as the first test followed by mCIM for rapid detection of CP-CRE. With this algorithm >80% of the CP-CRE could be detected within 24 hours from the time the sample is received and 100% CP-CRE could be detected in day two. In conclusion, mCIM was the most sensitive assay for the identification of CP-CRE. CNPt-direct performed better than CNPt. An algorithm consisting CNPt-direct and mCIM allows rapid and reliable detection of carbapenemase production in resource-limited settings. | en_US |
dc.language.iso | en_US | en_US |
dc.publisher | Public Library of Science | en_US |
dc.subject | Bacterial Proteins | |
dc.subject | Bacterial Proteins-analysis | en |
dc.subject | Bacterial Proteins-metabolism | en |
dc.subject | Carbapenem-Resistant Enterobacteriaceae | |
dc.subject | Carbapenem-Resistant Enterobacteriaceae-isolation & purification | |
dc.subject | Enterobacteriaceae Infections | |
dc.subject | Enterobacteriaceae Infections-diagnosis | |
dc.subject | Enterobacteriaceae Infections-microbiology | |
dc.subject | Enzyme Assays | en |
dc.subject | Enzyme Assays-methods | |
dc.subject | Sensitivity and Specificity | |
dc.subject | beta-Lactamases | |
dc.subject | beta-Lactamases-analysis | |
dc.subject | beta-Lactamases-metabolism | |
dc.subject | Comparative Study | en |
dc.title | Comparison of four low-cost carbapenemase detection tests and a proposal of an algorithm for early detection of carbapenemase-producing Enterobacteriaceae in resource-limited settings | en_US |
dc.type | Article | en_US |
Appears in Collections: | Journal/Magazine Articles |
Files in This Item:
File | Description | Size | Format | |
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Comparison of four low-cost carbapenemase.pdf | 576.21 kB | Adobe PDF | View/Open |
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