Evaluation Of Phenotypic Methods For Detection Of Carbapenem Resistance In Isolates Of Pseudomonas Aeruginosa In A Tertiary Care Hospital
DOI:
https://doi.org/10.51985/JBUMDC2019028Keywords:
carbapenem resistance, mCIM, MHT, Pseudomonas aeruginosa, PPV, NPV.Abstract
Objective: To assess the effectiveness of Modified Hodge test (MHT) and Modified carbapenemase inactivation method
(mCIM) for detection of carbapenemase enzyme produced by Pseudomonas aeruginosa strains that code for resistance
towards carbapenem.
Study Design and Setting: This observational cross sectional study was carried out from January 18 to January 19 in
microbiology department of PNS SHIFA Karachi.
Methodology: 140 isolates of Pseudomonas aeruginosa were cultured from pus samples of hospitalized patients from
different wards like ENT, Surgery, Burn Unit, Plastic Surgery, ICU, Medicine, Pediatrics and family ward. These isolates
were tested carbapenem resistance by two phenotypic methods namely MHT and mCIM test. This data was analyzed by
using SPSS Version 23.0.
Results: In our research study mCIM method showed 100% sensitivity, 99.1% specificity, positive predictive value 96.1%
and negative predictive value 100% as compare to Modified Hodge Test which gave 77% sensitivity, 99.1% specificity,
95.2% PPV and 100% NPV.
Conclusion: mCIM test is simple, accurate and more reliable method for detection of carbapenemase production as
compared with MHT. It is recommended, cabapenemase producing isolates should be tested as a routine practice by all
clinical labs laboratory.
References
Mishra SN, Biswal SR, Pattnaik D, Detection of prevalence of metallo beta lactamases in clinical isolates of imipenem resistant Pseudomonas aeruginosa from neonatal septicemia cases in a tertiary hospital in Odisha, India. Int J contemp pediatr. 2018; 5(1):61-66.
Basak S, Singh P, Rajurkar M. Multidrug resistant and extensively drug resistant bacteria: A study. Journal of pathogens. 2016; ID 4065603
Nathwani D, Raman G, Sulham K, Gavaghan M, Menon V. Clinical and economic consequences of hospital-acquired resistant and multidrug-resistant Pseudomonas aeruginosa infections: a systematic review and meta-analysis. Antimicrob Resist Infect Control. BioMed Central.2016; 3(1):32.
Buehrle DJ, Shields RK, Clarke LG, Potoski BA, Clancy CJ, Nguyen MH. Carbapenem-resistant Pseudomonas aeruginosa bacteremia: risk factors for mortality and microbiologic treatment failure. Antimicrob agents chemoth. 2017; 61(1):e01243-16.
Sultan BA, Khan E, Hussain F, Nasir A, Irfan S. Effectiveness of modified Hodge test to detect NDM-1 carbapenemases: an experience from Pakistan. J Pak Med Assoc. 2013; 63(8):955-60.
Bagul US, Sivakumar SM, antibiotic susceptibility testing: A Review on current practices. Int pharm. 2016; 6(3):11-17
Amjad A, Mirza IA, Abbasi SA, Farwa U, Malik N, Zia F. Modified Hodge test: A simple and effective test for detection of carbapenemase production. Iran J microbiol. 2011; 3(4):189.
Lisboa LF, Turnbull L, Boyd DA, Mulvey MR, Dingle TC. Evaluation of a Modified Carbapenem Inactivation Method for Detection of Carbapenemases in Pseudomonas aeruginosa. J clin microbiol. 2018; 56(1):e01234-17.
http://clsi.org/standards/micro/microbiology files]
CLSI. 2017. Performance standards for antimicrobial susceptibility testing. CLSI supplement M100, 27th ed Clinical and Laboratory Standards Institute, Wayne, PA.
Pierce VM, Simner PJ, Lonsway DR, Roe-Carpenter DE, Johnson JK, Brasso WB, Bobenchik AM, Lockett ZC, Charnot-Katsikas A, Ferraro MJ, Thomson RB. The modified carbapenem inactivation method (mCIM) for phenotypic detection of carbapenemase production among Enterobacteriaceae. Journal of clinical microbiology. 2017: JCM-00193.
Golle A, Janezic S, Rupnik M. Low overlap between carbapenem resistant Pseudomonas aeruginosa genotypes isolated from hospitalized patients and wastewater treatment plants. PloS one. 2017; 12(10):e0186736.
Al-Ahmadi GJ, Roodsari RZ. Fast and specific detection of Pseudomonas Aeruginosa from other pseudomonas species by PCR. Annals of burns and fire disasters. 2016; 29(4):264.
Ibrahim AH, Al Fadhil AO. Phenotypic Detection of Carbapenemase-producing K. pneumoniae isolated from Patients attending Hospital Settings in Khartoum. ajmsc. 2018; 3(2).
Walthall K, Anderson K, Reese N, Lonsway D, Kamile Rasheed J, Karlsson M. Evaluation of the RAPIDEC CARBA NP, Conventional CarbaNP, and the Modified Carbapenem Inactivation Method (mCIM) Tests for Phenotypic Detection of Carbapenemase-Producing Organisms. AJCP. 2018; 150(suppl_1):S123-4.
CLSI. Performance standards for antimicrobial susceptibility testing-CLSI document M100-Ed 29. 29th informational supplement-2019.
Buehrle DJ, Shields RK, Clarke LG, Potoski BA, Clancy CJ, Nguyen MH. Carbapenem-resistant Pseudomonas aeruginosa bacteremia: risk factors for mortality and microbiologic treatment failure. Antimicrob agents chemother. 2017; 61(1):e01243-16.
Pierce VM, Simner PJ, Lonsway DR, Roe-Carpenter DE, Johnson JK, Brasso WB, Bobenchik AM, Lockett ZC, Charnot-Katsikas A, Ferraro MJ, Thomson RB. Modified carbapenem inactivation method for phenotypic detection of carbapenemase production among Enterobacteriaceae. J clin microbiol. 2017; 55(8):2321-33.
Yu B, Dong D, Wang M, Guo Y, Yin D, Hu F. Evaluation of modified carbapenem inactivation method for suspected carbapenemase among Enterobacteriaceae clinical isolates. Oncotarget. 2018; 9(49):29233
Lee K, Lim YS, Yong D, Yum JH, Chong Y. Evaluation of the Hodge test and the imipenem-EDTA double-disk synergy test for differentiating metallo-beta-lactamase-producing isolates of Pseudomonas spp. and Acinetobacter spp. J clin microbiol. 2003; 41(10):4623-9.
Amjad A, Mirza IA, Abbasi SA, Farwa U, Malik N, Zia F. Modified Hodge test: A simple and effective test for detection of carbapenemase production. Iranian journal of microbiology. 2011;3(4):189.
Pasteran F, Gonzalez LJ, Albornoz E, Bahr G, Vila AJ, Corso A. Triton Hodge test: improved protocol for modified Hodge test for enhanced detection of NDM and other carbapenemase producers. Journal of clinical microbiology. 2016;54(3):640-9.
Othman HB, Halim RM, Abdul-Wahab HE, Atta HA, Shaaban O. Pseudomonas aeruginosa-Modified Hodge Test (PAE-MHT) and ChromID Carba Agar for Detection of Carbapenemase Producing Pseudomonas Aeruginosa Recovered from Clinical Specimens. Open access Maced j Med Sci. 2018; 6(12):2283.
Ghasemnejad A, Doudi M, Amirmozafari NO. Evaluation of modified hodge test as a non-molecular assay for accurate detection of KPC-producing Klebsiella pneumoniae. Pol j microbiol. 2018; 67(3):291-5.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2019 Shaista Bakhat, Yasmeen Taj, Faisal Hanif, Muhammad Faisal Faheem
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of Bahria University Medical & Dental College is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0