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Efficiency of Various Detection Methods for Carbapenem Resistance Gram negative bacteria in King Faisal Medical Complex Hospital, Taif. Saudi Arabia

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Last updated: 03 Jan 2025

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Abstract

Carbapenem resistance Gram-Negative bacteria (CR-GNB) impose life-threatening infections with limited treatment options. Rapid detection of CR-GNB-associated infections is usually associated with proper treatment and better disease prognosis. The aim of this study was to evaluate the efficacy of the Phoenix automated system, Modified Hodge Test (MHT) and X΄pert Carba-R assay for the detection of CR-GNB. A panel of 167 non-repetitive CR-GNB with reduced susceptibility to carbapenems which was identified by the Kirby-Bauer method was analyzed by means of 1) Phoenix automated system, 2) MHT, and 3) X΄pert Carba-R assay. The most accurate identification of resistance determinants was obtained with the Phoenix automated system that diagnosed and confirmed all carbapenem-resistant isolates (n=167/167, 100%). Just 57% of CR-GNB were identified by X΄pert Carba-R Assay whereas seventy-nine (n=79/99, 79.8%) of CR Klebsiella spp., (n=5/23, 21.7%) of CR Pseudomonas spp., (n=10/32, 31.25%) of CR Acinetobacter baumannii, and (n=4/13, 30.8%) of CR other bacteria were identified. MHT correctly identified 56/99 (56.6%) strains of CR Klebsiella spp., 12/23 (52.2%) strains of CR Pseudomonas spp., 18/32 (56.25%) strains of CR A. baumannii, and 2/13 (15.4%) strains of other CR bacteria. While according to carbapenemase producers' genes, MHT most successfully identified blaNDM+blaOXA pattern of carbapenem resistance strains (n=25/26, 96.2%), then sensitivity lowered when testing blaOXA positive strain with (n=17/30, 56.7%), and less than half blaNDM positive samples were recognized by MHT with (n=19/42, 45.2%), sensitivity and specificity of MHT to detect carbapenemase producers' bacteria were 69.3% and 60.9%, respectively. Phoenix automated system diagnosed all the carbapenemase producers' bacteria in all genetic patterns as carbapenem resistance isolates with one hundred percent sensitivity but without any specificity to carbapenmase mechanism among other CR mechanisms. In conclusion, to detect and control the spread of CR-GNB with complicated resistance mechanisms, phenotypic automated assays are recommended in the routine diagnostic of clinical laboratories, but genotypic assays are recommended in nosocomial infection control to detect carbapenemase producers.

DOI

10.21608/eajbsc.2022.281087

Keywords

Phoenix, X΄pert Carba-R Assay, Carbapenem resistance, Modified hodge test, Carbapenemase

Authors

First Name

Rawan

Last Name

Abou-Assy

MiddleName

S.

Affiliation

Department of Biology, College of Science, King Abdulaziz University, Jeddah, Saudi Arabia.

Email

-

City

Saudi Arabia

Orcid

-

First Name

Magda

Last Name

Aly

MiddleName

M.

Affiliation

Department of Biology, College of Science, King Abdulaziz University, Jeddah, Saudi Arabia. -Department of Botany and Microbiology, Faculty of Science, Kafrelsheikh University, Kafrelsheikh, Egypt.

Email

mmmohammad@kau.edu.sa

City

-

Orcid

-

First Name

Reda

Last Name

Amasha

MiddleName

H.

Affiliation

Department of Biology, College of Science, King Abdulaziz University, Jeddah, Saudi Arabia.

Email

-

City

Saudi Arabia

Orcid

-

First Name

Shaza

Last Name

Qattan

MiddleName

Y.

Affiliation

Department of Biology, College of Science, King Abdulaziz University, Jeddah, Saudi Arabia.

Email

-

City

Saudi Arabia

Orcid

-

First Name

Dakhel

Last Name

Althubyani

MiddleName

-

Affiliation

Department of Microbiology, King Faisal Medical Complex, Taif, Makkah, Saudi Arabia

Email

-

City

Saudi Arabia

Orcid

-

First Name

Saud

Last Name

Alharthi

MiddleName

-

Affiliation

Department of Microbiology, King Faisal Medical Complex, Taif, Makkah, Saudi Arabia

Email

-

City

Saudi Arabia

Orcid

-

Volume

14

Article Issue

2

Related Issue

35452

Issue Date

2022-12-01

Receive Date

2022-10-12

Publish Date

2022-12-15

Page Start

447

Page End

457

Print ISSN

2090-0767

Online ISSN

2090-083X

Link

https://eajbsc.journals.ekb.eg/article_281087.html

Detail API

https://eajbsc.journals.ekb.eg/service?article_code=281087

Order

281,087

Type

Original Article

Type Code

673

Publication Type

Journal

Publication Title

Egyptian Academic Journal of Biological Sciences. C, Physiology and Molecular Biology

Publication Link

https://eajbsc.journals.ekb.eg/

MainTitle

Efficiency of Various Detection Methods for Carbapenem Resistance Gram negative bacteria in King Faisal Medical Complex Hospital, Taif. Saudi Arabia

Details

Type

Article

Created At

22 Jan 2023