Approach to Carbapenemase Detection in Klebsiella pneumoniae in Routine Diagnostic Laboratories

Rangnekar Aseem, Shalini Shenoy, Suchitra Shenoy Mala, Shrikala Baliga, Agarwal Ashish

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

INTRODUCTION: Resistance to Carbapenems in Klebsiella may be due to Carbapenem hydrolysing enzymes. Accurate detection of carbapenemase must be done for patient treatment and epidemiological purposes.

AIM: To detect carbapenemase production by performing Modified Hodge Test (MHT), Combined Disk Test (CDT) for Metallo-β-Lactamases (MBL) and PCR for blaKPC gene, to evaluate the performance of MHT using MacConkey Agar (MCA) and to access the value of MHT for carbapenemase detection.

MATERIAL AND METHODS: Using a prospective laboratory study design, 153 Extended Spectrum Beta-Lactamases (ESBL) producing Klebsiella pneumoniae from clinical samples of patients admitted in the Kasturba Medical College were collected from January 2014 to December 2015. Isolates resistant to carbapenems by disk diffusion were subjected to MHT on MCA and Mueller Hinton agar (MHA). All isolates were tested for (MBL) production by Imipenem and Imipenem-EDTA CDT and subjected to PCR for the presence of blaKPC gene.

RESULTS: Out of 153 isolates, 54 were resistant to one of the carbapenems. Among these, 13 were positive for MHT on MHA, while 23 were positive by MHT on MCA. Number of MBL producers was 23 (42.5%), while blaKPC was detected in 2 out of the 54 isolates.

CONCLUSION: Though detection of drug resistance gene remains the method of choice, it can be performed only in centers with adequate resources. Hence, for most laboratories in resource poor countries, the MHT performed on MCA with concomitant CDT for MBL detection seem to be a better option for detection of Carbapenem resistance.

Original languageEnglish
Pages (from-to)DC24-DC27
JournalJournal of Clinical and Diagnostic Research
Volume10
Issue number12
DOIs
Publication statusPublished - 12-2016

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Klebsiella pneumoniae
Carbapenems
Agar
Imipenem
Genes
Patient treatment
Polymerase Chain Reaction
Klebsiella
beta-Lactamases
Drug Resistance
Edetic Acid
carbapenemase
Prospective Studies
Enzymes
Pharmaceutical Preparations

Cite this

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title = "Approach to Carbapenemase Detection in Klebsiella pneumoniae in Routine Diagnostic Laboratories",
abstract = "INTRODUCTION: Resistance to Carbapenems in Klebsiella may be due to Carbapenem hydrolysing enzymes. Accurate detection of carbapenemase must be done for patient treatment and epidemiological purposes.AIM: To detect carbapenemase production by performing Modified Hodge Test (MHT), Combined Disk Test (CDT) for Metallo-β-Lactamases (MBL) and PCR for blaKPC gene, to evaluate the performance of MHT using MacConkey Agar (MCA) and to access the value of MHT for carbapenemase detection.MATERIAL AND METHODS: Using a prospective laboratory study design, 153 Extended Spectrum Beta-Lactamases (ESBL) producing Klebsiella pneumoniae from clinical samples of patients admitted in the Kasturba Medical College were collected from January 2014 to December 2015. Isolates resistant to carbapenems by disk diffusion were subjected to MHT on MCA and Mueller Hinton agar (MHA). All isolates were tested for (MBL) production by Imipenem and Imipenem-EDTA CDT and subjected to PCR for the presence of blaKPC gene.RESULTS: Out of 153 isolates, 54 were resistant to one of the carbapenems. Among these, 13 were positive for MHT on MHA, while 23 were positive by MHT on MCA. Number of MBL producers was 23 (42.5{\%}), while blaKPC was detected in 2 out of the 54 isolates.CONCLUSION: Though detection of drug resistance gene remains the method of choice, it can be performed only in centers with adequate resources. Hence, for most laboratories in resource poor countries, the MHT performed on MCA with concomitant CDT for MBL detection seem to be a better option for detection of Carbapenem resistance.",
author = "Rangnekar Aseem and Shalini Shenoy and Mala, {Suchitra Shenoy} and Shrikala Baliga and Agarwal Ashish",
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Approach to Carbapenemase Detection in Klebsiella pneumoniae in Routine Diagnostic Laboratories. / Aseem, Rangnekar; Shenoy, Shalini; Mala, Suchitra Shenoy; Baliga, Shrikala; Ashish, Agarwal.

In: Journal of Clinical and Diagnostic Research, Vol. 10, No. 12, 12.2016, p. DC24-DC27.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Approach to Carbapenemase Detection in Klebsiella pneumoniae in Routine Diagnostic Laboratories

AU - Aseem, Rangnekar

AU - Shenoy, Shalini

AU - Mala, Suchitra Shenoy

AU - Baliga, Shrikala

AU - Ashish, Agarwal

PY - 2016/12

Y1 - 2016/12

N2 - INTRODUCTION: Resistance to Carbapenems in Klebsiella may be due to Carbapenem hydrolysing enzymes. Accurate detection of carbapenemase must be done for patient treatment and epidemiological purposes.AIM: To detect carbapenemase production by performing Modified Hodge Test (MHT), Combined Disk Test (CDT) for Metallo-β-Lactamases (MBL) and PCR for blaKPC gene, to evaluate the performance of MHT using MacConkey Agar (MCA) and to access the value of MHT for carbapenemase detection.MATERIAL AND METHODS: Using a prospective laboratory study design, 153 Extended Spectrum Beta-Lactamases (ESBL) producing Klebsiella pneumoniae from clinical samples of patients admitted in the Kasturba Medical College were collected from January 2014 to December 2015. Isolates resistant to carbapenems by disk diffusion were subjected to MHT on MCA and Mueller Hinton agar (MHA). All isolates were tested for (MBL) production by Imipenem and Imipenem-EDTA CDT and subjected to PCR for the presence of blaKPC gene.RESULTS: Out of 153 isolates, 54 were resistant to one of the carbapenems. Among these, 13 were positive for MHT on MHA, while 23 were positive by MHT on MCA. Number of MBL producers was 23 (42.5%), while blaKPC was detected in 2 out of the 54 isolates.CONCLUSION: Though detection of drug resistance gene remains the method of choice, it can be performed only in centers with adequate resources. Hence, for most laboratories in resource poor countries, the MHT performed on MCA with concomitant CDT for MBL detection seem to be a better option for detection of Carbapenem resistance.

AB - INTRODUCTION: Resistance to Carbapenems in Klebsiella may be due to Carbapenem hydrolysing enzymes. Accurate detection of carbapenemase must be done for patient treatment and epidemiological purposes.AIM: To detect carbapenemase production by performing Modified Hodge Test (MHT), Combined Disk Test (CDT) for Metallo-β-Lactamases (MBL) and PCR for blaKPC gene, to evaluate the performance of MHT using MacConkey Agar (MCA) and to access the value of MHT for carbapenemase detection.MATERIAL AND METHODS: Using a prospective laboratory study design, 153 Extended Spectrum Beta-Lactamases (ESBL) producing Klebsiella pneumoniae from clinical samples of patients admitted in the Kasturba Medical College were collected from January 2014 to December 2015. Isolates resistant to carbapenems by disk diffusion were subjected to MHT on MCA and Mueller Hinton agar (MHA). All isolates were tested for (MBL) production by Imipenem and Imipenem-EDTA CDT and subjected to PCR for the presence of blaKPC gene.RESULTS: Out of 153 isolates, 54 were resistant to one of the carbapenems. Among these, 13 were positive for MHT on MHA, while 23 were positive by MHT on MCA. Number of MBL producers was 23 (42.5%), while blaKPC was detected in 2 out of the 54 isolates.CONCLUSION: Though detection of drug resistance gene remains the method of choice, it can be performed only in centers with adequate resources. Hence, for most laboratories in resource poor countries, the MHT performed on MCA with concomitant CDT for MBL detection seem to be a better option for detection of Carbapenem resistance.

U2 - 10.7860/JCDR/2016/23036.9026

DO - 10.7860/JCDR/2016/23036.9026

M3 - Article

VL - 10

SP - DC24-DC27

JO - Journal of Clinical and Diagnostic Research

JF - Journal of Clinical and Diagnostic Research

SN - 2249-782X

IS - 12

ER -