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Carbapenem Resistance in Klebsiella pneumoniae Not Detected by Automated Susceptibility Testing

机译:自动化药敏试验未检出肺炎克雷伯菌对碳青霉烯的耐药性

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Detecting β-lactamase–mediated carbapenem resist-ance among Klebsiella pneumoniae isolates and otherEnterobacteriaceae is an emerging problem. In this study,15 blaKPC-positive Klebsiella pneumoniae that showed dis-crepant results for imipenem and meropenem from 4 NewYork City hospitals were characterized by isoelectric focus-ing; broth microdilution (BMD); disk diffusion (DD); andMicroScan, Phoenix, Sensititre, VITEK, and VITEK 2 auto-mated systems. All 15 isolates were either intermediate orresistant to imipenem and meropenem by BMD; 1 was sus-ceptible to imipenem by DD. MicroScan and Phoenix report-ed 1 (6.7%) and 2 (13.3%) isolates, respectively, asimipenem susceptible. VITEK and VITEK 2 reported 10(67%) and 5 (33%) isolates, respectively, as imipenem sus-ceptible. By Sensititre, 13 (87%) isolates were susceptibleto imipenem, and 12 (80%) were susceptible to meropen-em. The VITEK 2 Advanced Expert System changed 2imipenem MIC results from >16 μg/mL to <2 μg/mL but keptthe interpretation as resistant. The recognition of carbapen-em-resistant K. pneumoniae continues to challenge auto-mated susceptibility systems
机译:在肺炎克雷伯菌分离株和其他肠杆菌科中检测β-内酰胺酶介导的碳青霉烯耐药性是一个新出现的问题。在这项研究中,来自纽约市4家医院的15株blaKPC阳性肺炎克雷伯菌显示出亚胺培南和美洛培南的不良结果,以等电聚焦为特征。肉汤微稀释(BMD);磁盘扩散(DD); MicroScan,Phoenix,Sensititre,VITEK和VITEK 2自动化系统。 BMD对所有15个分离株均具有亚胺培南和美洛培南的抗性或抗性。 DD对亚胺培南敏感。 MicroScan和Phoenix分别报告了1个(6.7%)和2个(13.3%)分离株对亚胺培南敏感。 VITEK和VITEK 2分别报告有10个(67%)和5个(33%)分离株,易感亚胺培南。根据Sensititre的研究,有13(87%)个分离株易受亚胺培南的侵害,而12(80%)则易受美罗培南的侵害。 VITEK 2 Advanced Expert System将2imipenem MIC结果从> 16μg/ mL更改为<2μg/ mL,但仍保持了解释性。对耐碳青霉素-em的肺炎克雷伯氏菌的认可继续挑战自动药敏系统

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