Evaluation of Double-Disk Potentiation and Disk Potentiation Tests Using Dipicolinic Acid for Detection of Metallo-beta-Lactamase-Producing Pseudomonas spp. and Acinetobacter spp.

Title
Evaluation of Double-Disk Potentiation and Disk Potentiation Tests Using Dipicolinic Acid for Detection of Metallo-beta-Lactamase-Producing Pseudomonas spp. and Acinetobacter spp.
Author
이양순
Keywords
SYNERGY TEST; HODGE TEST; AERUGINOSA; KOREA; CARBAPENEM; DISSEMINATION; BLA(SIM-1); BAUMANNII; GENE
Issue Date
2012-07
Publisher
AMER SOC MICROBIOLOGY, 1752 N ST NW, WASHINGTON, DC 20036-2904 USA
Citation
JOURNAL OF CLINICAL MICROBIOLOGY, 50, 10, p3227-p3232
Abstract
Accurate detection of metallo-beta-lactamase (MBL)-producing Pseudomonas spp. and Acinetobacter spp. became very important with the increasing prevalence of carbapenem-nonsusceptible clinical isolates. The performance of phenotypic MBL detection methods may depend on the types of MBL and the characteristics of the isolates. A high false-positive rate is a problem with EDTA-based MBL detection methods. We evaluated the performance of double-disk potentiation tests (DDPTs) and disk potentiation tests (DPTs) with dipicolinic acid (DPA) using 44 isolates of Pseudomonas spp. and Acinetobacter spp. producing IMP-1-like, VIM-2-like, and SIM-1 type MBLs. Also, we characterized P. aeruginosa isolates with positive imipenem (IPM)-DPA DDPT, but negative meropenem (MEM)-DPA DDPT, and determined possibility of improving a DDPT by using MacConkey agar. Among five different DDPT methods, the IPM-DPA 250-mu g method showed the highest sensitivity (97.7%) and specificity (100%). Among four DPT tests, the highest sensitivity (100%) was shown by the IPM-EDTA 1,900-mu g disk method, but the specificity was very low (11.4%). Five of six P. aeruginosa isolates with false-negative DDPTs with MEM-DPA 250-mu g disks carried bla(IMP-6), and the high level resistance to MEM (MIC >= 512 mu g/ml) was reduced by the presence of phenylalanine arginine beta-naphtylamide. Improvement of DDPTs was observed when MacConkey agar was used instead of Mueller-Hinton agar. In conclusion, DPA is a better MBL inhibitor than EDTA for detection of Pseudomonas spp. and Acinetobacter spp. with IMP-1-like, VIM-2-like, and SIM-1-type MBLs. In DPA DDPTs, IPM disks perform better than MEM disks when the isolates are highly resistant to MEM due to the overexpression of efflux pumps.
URI
http://jcm.asm.org/content/50/10/3227.fullhttp://hdl.handle.net/20.500.11754/38055
ISSN
0095-1137
DOI
10.1128/JCM.00818-12
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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