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Ertapenem disk performance to predict Klebsiella pneumoniae carbapenemase produced by Gram-negative bacilli isolated in a São Paulo city public hospital.
- Source :
-
Einstein (Sao Paulo, Brazil) [Einstein (Sao Paulo)] 2012 Oct-Dec; Vol. 10 (4), pp. 439-41. - Publication Year :
- 2012
-
Abstract
- Objective: To evaluate ertapenem disk performance to predict Klebsiella pneumonie carbapenemase production by Gram-negative bacilli.<br />Methods: All Gram-negative bacilli isolated between January 2010 and June 2011 were tested by disk diffusion (Oxoid™) for sensitivity to ertapenem, meropenem and imipenem. Resistant or intermediate sensitivity strains (diameter < 22 mm for ertapenem) were also tested for the blaKPC gene by polymerase chain reaction. Disk predictive positive value for Klebsiella pneumoniae carbapenemase and specificity were calculated.<br />Results: Out of the 21839 cultures performed, 3010 (13.78%) were positive, and Gram-negative bacilli were isolated in 708 (23.52%) of them. Zone of inhibition diameter for ertapenem disk was < 22 mm for 111 isolates, representing 15.7% of all Gram-negative isolates. The PCR assay for blaKPC detected 40 Klebsiella pneumoniae carbapenemase-producing strains. No strains intermediate or resistant to meropenem and imipenem were sensitive to ertapenem. The ertapenem disk presented a positive predictive value of 36% to predict blaKPC and 89% specificity.<br />Conclusion: The resistance of Gram-negative bacilli detected by disk diffusion against ertapenem does not predict Klebsiella pneumoniae carbapenemase production. Other mechanisms, such as production of other betalactamases and porin loss, may be implicated. The need to confirm the presence of the blaKPC is suggested. Therefore, ertapenem was a weak predictor for discriminating strains that produce Klebsiella pneumoniae carbapenemase.
- Subjects :
- Bacterial Proteins analysis
Brazil
Ertapenem
Gram-Negative Bacteria isolation & purification
Humans
Klebsiella pneumoniae drug effects
Microbial Sensitivity Tests
Polymerase Chain Reaction
Predictive Value of Tests
beta-Lactam Resistance
beta-Lactamases analysis
Anti-Bacterial Agents pharmacology
Bacterial Proteins biosynthesis
Disk Diffusion Antimicrobial Tests methods
Klebsiella pneumoniae enzymology
beta-Lactamases biosynthesis
beta-Lactams pharmacology
Subjects
Details
- Language :
- English; Portuguese
- ISSN :
- 2317-6385
- Volume :
- 10
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Einstein (Sao Paulo, Brazil)
- Publication Type :
- Academic Journal
- Accession number :
- 23386083
- Full Text :
- https://doi.org/10.1590/s1679-45082012000400008