The online version of this article (doi:10.1186/s12879-017-2312-1) contains supplementary material, which is available to authorized users.
Identification of carbapenemase-producing Enterobacteriaceae (CPE) in faecal specimens is challenging. This fact is particularly critical because low-level carbapenem-resistant organisms such as IMP-producing CPE are most prevalent in Japan. We developed a modified selective medium more suitable for IMP-type CPE.
Fifteen reference CPE strains producing different types of β-lactamases were used to evaluate the commercially available CHROMagar KPC and chromID CARBA as well as the newly prepared MC-ECC medium (CHROMagar ECC supplemented with meropenem, cloxacillin, and ZnSO4) and M-ECC medium (CHROMagar ECC supplemented with meropenem and ZnSO4). A total of 1035 clinical samples were then examined to detect CPE using chromID CARBA and M-ECC medium.
All tested strains producing NDM-, KPC-, and OXA-48-carbapenemases were successfully cultured in the media employed. Although most of the IMP-positive strains did not grow in CHROMagar KPC, chromID CARBA, or MC-ECC, all tested strains grew on M-ECC. When faecal samples were applied to the media, M-ECC medium allowed the best growth of IMP-type CPE with a significantly higher sensitivity (99.3%) than that of chromID CARBA (13.9%).
M-ECC medium was determined as the most favourable selective medium for the detection of IMP-type CPE as well as other types of CPE.
Additional file 1: Table S1. MIC of meropenem reduction in bacterial isolates when cultured with 250 μg/mL of cloxacillin. (DOCX 37 kb)12879_2017_2312_MOESM1_ESM.docx
Additional file 2: Table S2. Characteristics of bacterial species detected in stool specimens via M-ECC and chromID CARBA. (DOCX 31 kb)12879_2017_2312_MOESM2_ESM.docx
Vrioni G, Daniil I, Voulgari E, Ranellou K, Koumaki V, Ghirardi S, Kimouli M, Zambardi G, Tsakris A. Comparative evaluation of a prototype chromogenic medium (ChromID CARBA) for detecting carbapenemase-producing Enterobacteriaceae in surveillance rectal swabs. J Clin Microbiol. 2012;50(6):1841–6. CrossRefPubMedPubMedCentral
Hayakawa K, Miyoshi-Akiyama T, Kirikae T, Nagamatsu M, Shimada K, Mezaki K, Sugiki Y, Kuroda E, Kubota S, Takeshita N, et al. Molecular and epidemiological characterization of IMP-type metallo-beta-lactamase-producing Enterobacter cloacae in a Large tertiary care hospital in Japan. Antimicrob Agents Chemother. 2014;58(6):3441–50. CrossRefPubMedPubMedCentral
Kayama S, Shigemoto N, Kuwahara R, Oshima K, Hirakawa H, Hisatsune J, Jove T, Nishio H, Yamasaki K, Wada Y, et al. Complete nucleotide sequence of the IncN plasmid encoding IMP-6 and CTX-M-2 from emerging carbapenem-resistant Enterobacteriaceae in Japan. Antimicrob Agents Chemother. 2015;59(2):1356–9. CrossRefPubMedPubMedCentral
Clinical and Laboratory Standards Institute. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; approved standard, vol. 32. 9th ed. Wayne: Clinical and Laboratory Standards Institute; 2012.
Perry JD, Naqvi SH, Mirza IA, Alizai SA, Hussain A, Ghirardi S, Orenga S, Wilkinson K, Woodford N, Zhang J, et al. Prevalence of faecal carriage of Enterobacteriaceae with NDM-1 carbapenemase at military hospitals in Pakistan, and evaluation of two chromogenic media. J Antimicrob Chemother. 2011;66(10):2288–94. CrossRefPubMed
- Development of selective medium for IMP-type carbapenemase-producing Enterobacteriaceae in stool specimens
Rathina Kumar Shanmugakani
- BioMed Central
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