medigraphic.com
ISSN 1561-3054 (Electronic)

2020, Number 3

<< Back Next >>

Rev Cubana Med Trop 2020; 72 (3)

Comparison of two commercial methods for determination of the minimum inhibitory meropenem concentration in KPC carbapenemase-producing Klebsiella pneumoniae

Soria-Segarra C, Berrezueta ML, Calderón J, Villacís JE, Soria-Segarra C, Quiñones D

Language: Spanish
References: 23
Page: 1-13
PDF size: 284.93 Kb.


ABSTRACT

Introduction: The treatment for KPC carbapenemase-producing Klebsiella pneumoniae infections is complicated, due to the scant therapeutic options available, which forces us to optimize the therapies at hand.
Objective: Determine the agreement between the AST-N272 card of the Vitek 2 Compact system and the M.I.C.E.TM Evaluator strips, and the agar dilution method for determination of the minimum inhibitory meropenem concentration in KPC carbapenemase-producing Klebsiella pneumoniae.
Methods: A study was conducted of 53 positive non-clonal K. pneumoniae bla KPC isolates from rectal swabs collected at several hospitals in Guayaquil, Ecuador, from January to June 2016. Minimum inhibitory meropenem concentration was determined by agar dilution (reference method), the Vitek 2 Compact system (AST-N272) and M.I.C.E.TM strips. Determination was made of MIC 50, MIC 90 and essential agreement.
Results: The meropenem MIC range for the isolates studied was 1 to ≥ 32 µg/ml, with MIC50= 4 µg/ml and MIC90= ≥ 32 µg/ml. In 86.79% (n= 46) of the isolates MIC was ≤ 8 µg/ml. Essential agreement was 94.33% with the M.I.C.E.TM strips and under 50% with the AST-N272 card.
Conclusions: The results obtained suggest potential implications for the treatment of patients, since therapeutic options are reduced in difficult management contexts. They also highlight the need for confirmation of carbapenem resistance by the Kirby-Bauer procedure in laboratories equipped with automated methods for susceptibility studies.


REFERENCES

  1. Borer A, Odes LS, Riesenberg K. Attributable Mortality Rate for Carbapenem-Resistant Klebsiella pneumoniae Bacteremia. Infect Control Hosp Epidemiol. 2014;30(10):972-76. doi: 10.1086/605922

  2. Patel G, Huprikar S, Factor SH, Jenkins SG, Calfee DP. Outcomes of Carbapenem-Resistant Klebsiella pneumoniae Infection and the Impact of Antimicrobial and Adjunctive Therapies. Infect Control Hosp Epidemiol. 2008;29(12):1099-1106. doi: 10.1086/592412

  3. Pierce VM, Simner PJ, Lonsway DR. Modified carbapenem inactivation method for phenotypic detection of carbapenemase production among enterobacteriaceae. J Clin Microbiol. 2017;55(8):2321-33. doi: 10.1128/JCM.00193-17

  4. Mo Y, Lorenzo M, Farghaly S, Kaur K, Housman ST. What's new in the treatment o multidrug-resistant gram-negative infections. Diagn Microbiol Infect Dis. 2019;93(20:171-181. doi: 10.1016/j.diagmicrobio.2018.08.007

  5. Tzouvelekis LS, Markogiannakis A, Piperaki E, Souli M, Daikos GL. Treating infections caused by carbapenemase-producing Enterobacteriaceae. Clin Microbiol Infect. 2014;20(9):862-72. doi: 10.1111/1469-0691.12697

  6. Petrosillo N, Giannella M, Lewis R, Viale P. Treatment of Carbapenem-resistant Klebsiella Pneumoniae The State of the Art. Expert Rev Anti Infect Ther. 2013;11(2):159-77. doi: 10.1586/eri.12.162

  7. Lorente L, Lorenzo L, Martín MM. Meropenem by continuous versus intermittent infusion in ventilator-associated pneumonia due to gram-negative bacilli. Ann Pharmacother. 2006;40(2):219-23. doi:10.1345/aph.1G467

  8. Tumbarello M, Viale P, Viscoli C. Predictors of mortality in bloodstream infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae: Importance of combination therapy. Clin Infect Dis. 2012;55(7):943-50. doi: 10.1093/cid/cis588

  9. Tumbarello M, Trecarichi EM, Rosa FG De. Infections caused by KPC-producing Klebsiella pneumoniae: Differences in therapy and mortality in a multicentre study. J Antimicrob Chemother. 2015;70(7):2133-43. doi: 10.1093/jac/dkv086

  10. Daikos GL, Markogiannakis A. Carbapenemase-producing Klebsiella pneumoniae: (When) might we still consider treating with carbapenems. Clin Microbiol Infect. 2011;17(8):1135-41. doi:10.1111/j.1469-0691.2011.03553

  11. Bulik CC, Fauntleroy KA, Jenkins SG. Comparison of meropenem CIMs and susceptibilities for carbapenemase- producing Klebsiella pneumoniae isolates by various testing methods. J Clin Microbiol. 2010;48(7):2402-06. doi: 10.1128/JCM.00267-10

  12. Lat A, Clock SA, Wu F. Comparison of polymyxin B, tigecycline, cefepime, and meropenem CIMs for KPC-producing Klebsiella pneumoniae by broth Microdilution, vitek 2, and etest. J Clin Microbiol. 2011;49(5):1795-98. doi: 10.1128/JCM.02534-10

  13. Bratu S, Landman D, Haag R. Rapid Spread of Carbapenem-Resistant Klebsiella pneumoniae in New York City. Arch Intern Med. 2005;165(12):1430. doi: 10.1001/archinte.165.12.1430

  14. Oteo J, Ortega A, Bartolomé R. Prospective multicenter study of carbapenemase-producing Enterobacteriaceae from 83 hospitals in Spain reveals high in vitro susceptibility to colistin and meropenem. Antimicrob Agents Chemother. 2015;59(6):3406-12. doi: 10.1128/AAC.00086-15

  15. Yu H, Qu F, Shan B. Detection of the mcr-1 colistin resistance gene in carbapenem-resistant Enterobacteriaceae from different hospitals in China. Antimicrob Agents Chemother. 2016;60(8):5033-5. doi: 10.1128/AAC.00440-16

  16. Poirel L, Walsh TR, Cuvillier V, Nordmann P. Multiplex PCR for detection of acquired carbapenemase genes. Diagn Microbiol Infect Dis. 2011;70(1):119-23. doi: 10.1016/j.diagCIMrobio.2010.12.002

  17. Clinical Laboratory Standards Institute. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically; Approved Standard - Ninth Edition. Vol 32. Wayne, PA, USA: CLSI; 2012.

  18. Clinical and Laboratory Standards Institute. Performance Standards for AntiCIMrobial Susceptibility Testing: Twenty-Sixth Informational Supplement M100-S26. Wayne, PA, USA: CLSI; 2016.

  19. Hunt AC, Gibb AP. Investigation of Enterobacteriaceae isolates found to have a raised meropenem CIM by vitek 2. J Antimicrob Chemother. 2012;67(4):1045-6. doi: 10.1093/jac/dkr574

  20. Mushtaq S, Warner M, Cloke J, Afzal-shah M, Livermore DM. Performance of the Oxoid M. I. C. Evaluator TM Strips compared with the Etest assay and BSAC agar dilution. J Antimicrob Chem. 2010;65:1702-11. doi: ?10.1093/jac/dkq206

  21. Campana EH, Carvalhaes CG, Nonato B, Machado AMDO, Gales AC. Comparison of M.I.C.E. and Etest with CLSI agar dilution for antimicrobial susceptibility testing against oxacillin-resistant Staphylococcus spp. PLoS One. 2014;9(4). doi: ?10.1371/journal.pone.0094627

  22. Rossatto FCP, Proença LA, Becker AP, Silveira AC de O, Caierão J, D'azevedo PA. Evaluation of Methods in Detecting Vancomycin CIM Among Mrsa Isolates and the Changes in Accuracy Related To Different CIM Values. Rev Inst Med Trop Sao Paulo. 2014;56(6):469-72. doi: 10.1590/S0036-46652014000600002

  23. Pasteran F, Lucero C, Soloaga R, Rapoport M, Corso A. Can we use imipenem and meropenem Vitek 2 CIMs for detection of suspected KPC and other-carbapenemase producers among species of Enterobacteriaceae. J Clin Microbiol. 2011;49(2):697-701. doi: 10.1128/JCM.01178-10




2020     |     www.medigraphic.com