Evaluation of Combined Use of Temocillin Disk and Mastdisks Inhibitor Combination Set Against Polymerase Chain Reaction for Detection of Carbapenem-Resistant Enterobacteriaceae

  • Omnia A. Shaker Clinical Pathology Department - Faculty of Medicine - Ain Shams University, Cairo
  • Howayda Ezz El Din Gomaa Clinical Pathology Department -National Research Centre - Egypt, Cairo http://orcid.org/0000-0002-3444-5898
  • Shereen A. ElMasry Clinical Pathology Department - Faculty of Medicine - Ain Shams University, Cairo
  • Rania M. Abdel Halim Clinical Pathology Department - Faculty of Medicine - Ain Shams University, Cairo
  • Amany H. Abdelrahman Clinical Pathology Department -National Research Centre - Egypt, Cairo
  • Jackline S. Kamal Clinical Pathology Department -National Research Centre - Egypt, Cairo
Keywords: Enterobacteriaceae, Carbapenemases, Mastdisks inhibitor, Temocillin

Abstract

AIMS: To evaluate the diagnostic performance of MDI and temocillin disk (30 μg) for detection of carbapenem-resistant Enterobacteriaceae in comparison to real-time PCR.

METHODS AND RESULTS: Fifty specimens submitted to the Microbiology Laboratory of Ain Shams University Hospitals and showed resistance to carbapenem drugs through routine culture and susceptibility testing, were assessed by both temocillin disk (30 μg) and MDI set to detect carbapenem-resistant Enterobacteriaceae. Results were compared to real-time PCR for detection of carbapenemase genes blaKPC, blaNDM, blaOXA–48-like, blaVIM, and blaIMP. Our work revealed that most of the CPE isolates were Klebsiella species (62%) followed by E. coli (24%), Serratia (10%) and Citrobacter (4%). Phenotypic detection of carbapenem-resistant classes revealed OXA - 48 in 96% of isolates, followed by MBLs (82%), and KPC (34%).  All isolates were negative for AmpC.  Detection of the genes by real-time PCR showed that the predominance was for the blaOXA-48 gene (96%) then blaVIM (94%) followed by blaNDM (54%), blaKPC (46%) and finally blaIMP (40%). Evaluation of the MDI set against PCR showed sensitivity (82.1%) and specificity (70%). The temocillin disk had 97.9% sensitivity and 50% specificity.  The evaluation of Temocillin disk and MDI in combination for detection of carbapenem-resistant Enterobacteriaceae showed 99.7% sensitivity and 35% specificity.

CONCLUSIONS: Adding Temocillin disk to Mastdisks ID inhibitor combination set provides a simple, easy, rapid and highly sensitive test that can be used for screening and classification of carbapenem-resistant Enterobacteriaceae. However, it still needs confirmation by molecular techniques.

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Published
2018-02-01
How to Cite
1.
Shaker OA, Gomaa HEED, ElMasry SA, Abdel Halim RM, Abdelrahman AH, Kamal JS. Evaluation of Combined Use of Temocillin Disk and Mastdisks Inhibitor Combination Set Against Polymerase Chain Reaction for Detection of Carbapenem-Resistant Enterobacteriaceae. Open Access Maced J Med Sci [Internet]. 2018Feb.1 [cited 2020Nov.25];6(2):242-7. Available from: https://www.id-press.eu/mjms/article/view/oamjms.2018.090
Section
A - Basic Science