Volume 4, Issue 3 (2018)
IEM 2018, 4(3): 99-103 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Boustanshenas M, Defaee S, Majidpour A, Afshar M, Mohammadi Azad Z, Ferasati M, et al . Reliability of MIC Gradient Strips (E-test) in Detection of Colistin Resistant Acinetobacter baumannii Caused an Outbreak in a Teaching Hospital in Tehran. IEM 2018; 4 (3) :99-103
URL: http://iem.modares.ac.ir/article-4-26508-en.html
URL: http://iem.modares.ac.ir/article-4-26508-en.html
M. Boustanshenas1 
, S. Defaee2 , A. Majidpour3 , M. Afshar1 , Z. Mohammadi Azad1 , M. Ferasati2 , N. Namdari Moghadam2 , M. Jamshidi-Makiani * 4
, S. Defaee2 , A. Majidpour3 , M. Afshar1 , Z. Mohammadi Azad1 , M. Ferasati2 , N. Namdari Moghadam2 , M. Jamshidi-Makiani * 4
1- Antimicrobial Resistance Research Center, Institute of Immunology & Infectious Disease, Iran University of Medical Sciences, Tehran Iran
2- Infectious Disease Department, Medicine Faculty, Iran University of Medical Sciences, Tehran, Iran
3- “Antimicrobial Resistance Research Center, Institute of Immunology & Infectious Disease” and “Infectious Diseases & Tropical Medicine Department, Medicine Faculty”, Iran University of Medical Sciences, Tehran, Iran
4- “Antimicrobial Resistance Research Center, Institute of Immunology & Infectious Disease” and “Infectious Diseases & Tropical Medicine Department, Medicine Faculty”, Iran University of Medical Sciences, Tehran, Iran ,mahinjamshidi42@gmail.com
2- Infectious Disease Department, Medicine Faculty, Iran University of Medical Sciences, Tehran, Iran
3- “Antimicrobial Resistance Research Center, Institute of Immunology & Infectious Disease” and “Infectious Diseases & Tropical Medicine Department, Medicine Faculty”, Iran University of Medical Sciences, Tehran, Iran
4- “Antimicrobial Resistance Research Center, Institute of Immunology & Infectious Disease” and “Infectious Diseases & Tropical Medicine Department, Medicine Faculty”, Iran University of Medical Sciences, Tehran, Iran ,
Abstract: (5627 Views)
Aims: Colistin resistant Acinetobacter baumannii strains have become an important treat in nosocomial infection control. The reliable detection of these strains plays a critical role in treatment procures. The aim of this study was to evaluate the three different methods in detection of colistin resistant A. baumannii strains.
Materials & Methods: Eighty-three A. baumannii strains were isolated from hospitalized patients of a teaching hospital in Tehran during 1 year (2016-2017). All isolates were genetically confirmed by Polymerase Chain Reaction (PCR). The resistance to colistin was determined with disc diffusion, E-test, and micro broth dilution method.
Findings: According to the results of micro broth dilution as a gold standard, 43% of the isolates were resistant to colistin, while this percentage was 23% and 44% through E-test and disc diffusion methods, respectively. The positive and negative predictive value (PPV and NPV) of this method was 43% and 57%, respectively. The sensitivity and NPV index of E-test for the detection of colistin resistant strains was 76% and 68%.
Conclusion: Detection of colistin MIC by E-test strips has been commonly used in clinical laboratories to recognize the colistin susceptible strains. The NPV and sensitivity of E-test method demonstrated that this method has inefficacy to accurate determination of colistin susceptible strains. Thus, using standard protocol micro broth dilution with qualified materials should be stabilized and replaced instead of disc diffusion or even using E-test in clinical laboratories.
Materials & Methods: Eighty-three A. baumannii strains were isolated from hospitalized patients of a teaching hospital in Tehran during 1 year (2016-2017). All isolates were genetically confirmed by Polymerase Chain Reaction (PCR). The resistance to colistin was determined with disc diffusion, E-test, and micro broth dilution method.
Findings: According to the results of micro broth dilution as a gold standard, 43% of the isolates were resistant to colistin, while this percentage was 23% and 44% through E-test and disc diffusion methods, respectively. The positive and negative predictive value (PPV and NPV) of this method was 43% and 57%, respectively. The sensitivity and NPV index of E-test for the detection of colistin resistant strains was 76% and 68%.
Conclusion: Detection of colistin MIC by E-test strips has been commonly used in clinical laboratories to recognize the colistin susceptible strains. The NPV and sensitivity of E-test method demonstrated that this method has inefficacy to accurate determination of colistin susceptible strains. Thus, using standard protocol micro broth dilution with qualified materials should be stabilized and replaced instead of disc diffusion or even using E-test in clinical laboratories.
Article Type: Original Research |
Subject:
Bacteriology
Received: 2018/04/26 | Accepted: 2018/06/10 | Published: 2018/09/22
Received: 2018/04/26 | Accepted: 2018/06/10 | Published: 2018/09/22
References
1. Lautenbach E, Synnestvedt M, Weiner MG, Bilker WB, Vo L, Schein J, et al. Epidemiology and impact of imipenem resistance in Acinetobacter baumannii. Infect Control Hosp Epidemiol. 2009; 30(12):1186-92. [Link] [DOI:10.1086/648450]
2. Sievert DM, Ricks P, Edwards JR, Schneider A, Patel J, Srinivasan A, et al. Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009-2010. Infect Control Hosp Epidemiol. 2013;34(1):1-14. [Link] [DOI:10.1086/668770]
3. Boucher HW, Talbot GH, Bradley JS, Edwards JE, Gilbert D, Rice LB, et al. Bad bugs, no drugs: No ESKAPE! an update from the Infectious Diseases Society of America. Clin Infect Dis. 2009;48(1):1-12. [Link] [DOI:10.1086/595011]
4. Fournier PE, Richet H. The epidemiology and control of Acinetobacter baumannii in health care facilities. Clin Infect Dis. 2006;42(5):692-9. [Link] [DOI:10.1086/500202]
5. Simor AE, Lee M, Vearncombe M, Jones-Paul L, Barry C, Gomez M, et al. An outbreak due to multiresistant Acinetobacter baumannii in a burn unit: Risk factors for acquisition and management. Infect Control Hosp Epidemiol. 2002;23(5):261-7. [Link] [DOI:10.1086/502046]
6. Cisneros JM, Rodríguez-Ba-o J, Fernández-Cuenca F, Ribera A, Vila J, Pascual A, et al. Risk-factors for the acquisition of imipenem-resistant Acinetobacter baumannii in Spain: A nationwide study. Clin Microbiol Infect. 2005;11(11):874-9. [Link] [DOI:10.1111/j.1469-0691.2005.01256.x]
7. Lee SO, Kim NJ, Choi SH, Hyong Kim T, Chung JW, Woo JH, et al. Risk factors for acquisition of imipenem-resistant Acinetobacter baumannii: A case-control study. Antimicrob Agents Chemother. 2004;48(1):224-8. [Link] [DOI:10.1128/AAC.48.1.224-228.2004]
8. Ye JJ, Huang CT, Shie SS, Huang PY, Su LH, Chiu CH, et al. Multidrug resistant Acinetobacter baumannii: Risk factors for appearance of imipenem resistant strains on patients formerly with susceptible strains. PLoS One. 2010;5(4):e9947. [Link] [DOI:10.1371/journal.pone.0009947]
9. Chan MC, Chiu SK, Hsueh PR, Wang NC, Wang CC, Fang CT. Risk factors for healthcare-associated extensively drug-resistant Acinetobacter baumannii infections: A case-control study. PLoS One. 2014;9(1):e85973. [Link] [DOI:10.1371/journal.pone.0085973]
10. Dijkshoorn L, Aucken H, Gerner-Smidt P, Janssen P, Kaufmann ME, Garaizar J, et al. Comparison of outbreak and nonoutbreak Acinetobacter baumannii strains by genotypic and phenotypic methods. J Clin Microbiol. 1996;34(6):1519-25. [Link]
11. Wiese A, Gutsmann T, Seydel U. Towards antibacterial strategies: Studies on the mechanisms of interaction between antibacterial peptides and model membranes. J Endotoxin Res. 2003;9(2):67-84.
https://doi.org/10.1179/096805103125001441 [Link] [DOI:10.1177/09680519030090020101]
12. Bialvaei AZ, Samadi Kafil H. Colistin, mechanisms and prevalence of resistance. Curr Med Res Opin. 2015;31(4):707-21. [Link] [DOI:10.1185/03007995.2015.1018989]
13. Cai Y, Chai D, Wang R, Liang B, Bai N. Colistin resistance of Acinetobacter baumannii: Clinical reports, mechanisms and antimicrobial strategies. J Antimicrob Chemother. 2012;67(7):1607-15. [Link] [DOI:10.1093/jac/dks084]
14. Hejnar P, Kolár M, Hájek V. Characteristics of Acinetobacter strains (phenotype classification, antibiotic susceptibility and production of beta-lactamases) isolated from haemocultures from patients at the Teaching Hospital in Olomouc. Acta Univ Palacki Olomuc Fac Med. 1999;142:73-7. [Link]
15. Szejbach A, Mikucka A, Bogiel T, Gospodarek E. Usefulness of phenotypic and genotypic methods for metallo-beta-lactamases detection in carbapenem-resistant Acinetobacter baumannii strains. Med Sci Monit Basic Res. 2013;19:32-6. [Link] [DOI:10.12659/MSMBR.883744]
16. Šimundić AM. Measures of diagnostic accuracy: Basic definitions. EJIFCC. 2009;19(4):203-11. [Link]
17. Kempf M, Rolain JM. Emergence of resistance to carbapenems in Acinetobacter baumannii in Europe: Clinical impact and therapeutic options. Int J Antimicrob Agents. 2012;39(2):105-14. [Link] [DOI:10.1016/j.ijantimicag.2011.10.004]
18. Queenan AM, Pillar CM, Deane J, Sahm DF, Lynch AS, Flamm RK, et al. Multidrug resistance among Acinetobacter spp. in the USA and activity profile of key agents: Results from CAPITAL Surveillance 2010. Diagn Microbiol Infect Dis. 2012;73(3):267-70. [Link] [DOI:10.1016/j.diagmicrobio.2012.04.002]
19. Bergogne-Bérézin E, Towner KJ. Acinetobacter spp. as nosocomial pathogens: Microbiological, clinical, and epidemiological features. Clin Microbiol Rev. 1996;9(2):148-65. [Link] [DOI:10.1128/CMR.9.2.148]
20. Doi Y, Murray GL, Peleg AY. Acinetobacter baumannii: Evolution of antimicrobial resistance-treatment options. Semin Respir Crit Care Med. 2015;36(1):85-98. [Link] [DOI:10.1055/s-0034-1398388]
21. Li J, Rayner CR, Nation RL, Deans R, Boots R, Widdecombe N, et al. Pharmacokinetics of colistin methanesulfonate and colistin in a critically ill patient receiving continuous venovenous hemodiafiltration. Antimicrob Agents Chemother. 2005;49(11):4814-5. [Link] [DOI:10.1128/AAC.49.11.4814-4815.2005]
22. Hawley JS, Murray CK, Jorgensen JH. Colistin heteroresistance in Acinetobacter and its association with previous colistin therapy. Antimicrob Agents Chemother. 2008;52(1):351-2. [Link] [DOI:10.1128/AAC.00766-07]
23. Vakili B, Fazeli H, Shoaei P, Yaran M, Ataei B, Khorvash F, et al. Detection of colistin sensitivity in clinical isolates of Acinetobacter baumannii in Iran. J Res Med Sci. 2014;19 Suppl 1:S67-70. [Link]
24. Bahador A, Taheri M, Pourakbari B, Hashemizadeh Z, Rostami H, Mansoori N, et al. Emergence of rifampicin, tigecycline, and colistin-resistant Acinetobacter baumannii in Iran, spreading of MDR strains of novel International Clone variants. Microb Drug Resist. 2013;19(5):397-406. [Link] [DOI:10.1089/mdr.2012.0233]
25. Moradi J, Hashemi FB, Bahador A. Antibiotic resistance of Acinetobacter baumannii in Iran: A systemic review of the published literature. Osong Public Health Res Perspect. 2015;6(2):79-86. [Link] [DOI:10.1016/j.phrp.2014.12.006]
26. Chew KL, La MV, Lin RTP, Teo JWP. Colistin and polymyxin B susceptibility testing for carbapenem-resistant and mcr-positive enterobacteriaceae: Comparison of sensititre, microscan, vitek 2, and etest with broth microdilution. J Clin Microbiol. 2017;55(9):2609-16. [Link] [DOI:10.1128/JCM.00268-17]
27. Matuschek E, Åhman J, Webster C, Kahlmeter G. Antimicrobial susceptibility testing of colistin - evaluation of seven commercial MIC products against standard broth microdilution for Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter spp. Clin Microbiol Infect. 2018;24(8):865-70. [Link] [DOI:10.1016/j.cmi.2017.11.020]
28. Turlej-Rogacka A, Xavier BB, Janssens L, Lammens C, Zarkotou O, Pournaras S, et al. Evaluation of colistin stability in agar and comparison of four methods for MIC testing of colistin. Eur J Clin Microbiol Infect Dis. 2018;37(2):345-53. [Link] [DOI:10.1007/s10096-017-3140-3]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |