Introduction
Materials and methods
Results
Species | β-lactamase content | No. of strains | MICs(μg/mL) of BMD | AST-N404 | AST-N268 | XN17 | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Carbapenemase | ESBLs/PABL | IPM | MEPM | IPM | MEPM | IPM | MEPM | FRPM | ETPM | CFX | LMOX | TAZ/PIPC | TAZ/CTLZ | AVI/CAZ | ||
C. freundii [8] | IMP-1 | 2 | 4 | 16 | 4 to ≥ 16 | ≥ 16 | 8 to ≥ 16 | ≥ 16 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | ≥ 128 | 16 | ≥ 16 | |
IMP-6 | CTX-M-2 | 4 | ≤ 0.5 to 2 | 4 to > 16 | 1 | 8 to ≥ 16 | 0.5 to 4 | 8 to ≥ 16 | ≥ 8 | 1 to ≥ 8 | ≥ 64 | ≥ 64 | ≤ 4 | 2 to 8 | 2 to ≥ 16 | |
IMP-19 | 1 | > 16 | > 16 | 8 | ≥ 16 | 8 | ≥ 16 | ≥ 8 | 1 | ≥ 64 | ≥ 64 | ≥ 128 | 16 | ≤ 0.12 | ||
VIM-2 | 1 | 2 | ≤ 0.5 | 1 | 4 | 2 | 4 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | ≥ 128 | 16 | ≥ 16 | ||
E. cloacae [7] | IMP-1 | 4 | 1 to 2 | 2 to 8 | 1 to 8 | ≥ 16 | 8 to ≥ 16 | ≥ 16 | ≥ 8 | 1 to ≥ 8 | ≥ 64 | ≥ 64 | 64 to ≥ 128 | 16 to ≥ 32 | ≥ 16 | |
IMP-1, GES-4 | 1 | 8 | 16 | 8 | ≥ 16 | ≥ 16 | ≥ 16 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | ≥ 128 | 16 | ≥ 16 | ||
IMP-6 | CTX-M-2 | 1 | 1 | > 16 | 0.5 | ≥ 16 | ≤ 0.25 | ≥ 16 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | 16 | ≥ 32 | ≥ 16 | |
VIM-2 | 1 | 1 | 1 | ≥ 16 | ≥ 16 | ≥ 16 | ≥ 16 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | 8 | ≥ 32 | ≥ 16 | ||
E. coli [17] | IMP-6 | 1 | 2 | > 16 | 1 | ≥ 16 | ≤ 0.25 | ≥ 16 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | ≤ 4 | ≥ 32 | ≥ 16 | |
IMP-6 | CTX-M-2 | 12 | ≤ 0.5 | ≤ 0.5 to > 16 | ≤ 0.25 to 4 | ≥ 16 | ≤ 0.25 to 4 | ≥ 16 | 4 to ≥ 8 | 0.25 to ≥ 8 | ≥ 64 | ≥ 64 | ≤ 4 to 32 | 4 to ≥ 32 | 2 to ≥ 16 | |
IMP-6 | CTX-M-2, -M-14 | 2 | 1 | > 16 | ≤ 0.25 | ≥ 16 | ≤ 0.25 | ≥ 16 | ≥ 8 | 2 to ≥ 8 | ≥ 64 | ≥ 64 | ≤ 4 | 8 | ≥ 16 | |
IMP-6 | CTX-M-2, -M-27 | 1 | 1 | 16 | 1 | ≥ 16 | 2 | ≥ 16 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | ≤ 4 | ≥ 32 | ≥ 16 | |
NDM-5 | CTX-M-65 | 1 | 8 | > 16 | ≥ 16 | ≥ 16 | ≥ 16 | ≥ 16 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | ≥ 128 | ≥ 32 | ≥ 16 | |
K. aerogenes [1] | IMP-6 | CTX-M-2 | 1 | ≤ 0.5 | > 16 | 4 | ≥ 16 | 4 | ≥ 16 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | ≥ 128 | ≥ 32 | ≥ 16 |
K. oxytoca [4] | IMP-6 | CTX-M-2 | 1 | ≤ 0.5 | > 16 | ≤ 0.25 | ≥ 16 | ≤ 0.25 | ≥ 16 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | 16 | ≥ 32 | ≥ 16 |
IMP-34 | 3 | ≤ 0.5 | 4 to > 16 | ≤ 0.25 to 2 | ≥ 16 | ≤ 0.25 to 2 | ≥ 16 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | ≤ 4 to 16 | 8 to ≥ 32 | 8 to ≥ 16 | ||
K. pneumoniae (50) | GES-4 | 4 | ≤ 0.5 to 1 | ≤ 0.5 to 1 | 2 to 4 | 1 | 2 to ≥ 16 | 1 to 4 | ≥ 8 | 0.25 to 2 | ≥ 64 | ≤ 4 to 8 | 64 to ≥ 128 | 8 to ≥ 32 | 0.25 to 1 | |
GES-4 | CTX-M-15 | 1 | 1 | 1 | 4 | 1 | 4 | 4 | ≥ 8 | 2 | ≥ 64 | 8 | ≥ 128 | ≥ 32 | 1 | |
IMP-1 | 2 | ≤ 0.5 to 4 | 4 to 8 | 8 to ≥ 16 | ≥ 16 | 8 to ≥ 16 | ≥ 16 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | 8 to ≥ 128 | ≥ 32 | ≥ 16 | ||
IMP-6 | 1 | 2 | 8 | 8 | ≥ 16 | ≥ 16 | ≥ 16 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | 64 | ≥ 32 | ≥ 16 | ||
IMP-6 | CTX-M-2 | 34 | ≤ 0.5 to 2 | ≤ 0.5 to > 16 | ≤ 0.25 to 4 | ≤ 0.25 to ≥ 16 | ≤ 0.25 to 2 | ≤ 0.25 to ≥ 16 | 4 to ≥ 8 | 0.25 to ≥ 8 | 32 to ≥ 64 | 16 to ≥ 64 | ≤ 4 to ≥ 128 | 2 to ≥ 32 | 1 to ≥ 16 | |
IMP-6 | CTX-M-2, DHA | 1 | 1 | > 16 | 2 | ≥ 16 | 2 | ≥ 16 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | 32 | 8 | ≥ 16 | |
IMP-8 | 1 | 8 | 8 | ≥ 16 | 4 | ≥ 16 | 4 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | ≥ 128 | ≥ 32 | ≥ 16 | ||
IMP-19 | CTX-M-1 | 1 | 0.5 | 0.25 | 4 | 4 | ≥ 16 | 4 | ≥ 8 | 0.25 | ≥ 64 | ≥ 64 | 8 | ≥ 32 | ≥ 16 | |
IMP-19 | CTX-M-3 | 1 | 1 | 0.25 | 4 | 1 | ≥ 16 | 1 | ≥ 8 | 1 | ≥ 64 | ≥ 64 | 16 | ≥ 32 | ≥ 16 | |
IMP-34 | 1 | 1 | 2 | 8 | ≥ 16 | ≥ 16 | ≥ 16 | ≥ 8 | 2 | ≥ 64 | ≥ 64 | 32 | ≥ 32 | ≥ 16 | ||
KPC-2 | CTX-M-14 | 1 | > 16 | > 16 | ≥ 16 | ≥ 16 | ≥ 16 | ≥ 16 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | ≥ 128 | ≥ 32 | 1 | |
OXA-48 | 1 | 1 | 0.5 | 4 | 4 | 4 | 2 | ≥ 8 | ≥ 8 | ≤ 4 | 16 | ≥ 128 | 1 | 0.25 | ||
OXA-181 | 1 | 2 | 1 | 2 | 1 | 2 | 2 | ≥ 8 | ≥ 8 | 16 | 16 | ≥ 128 | ≥ 32 | 0.5 | ||
M. morganii [1] | IMP-1 | 1 | 8 | 16 | ≥ 16 | 4 | 1 | 4 | ≥ 8 | 0.5 | ≥ 64 | ≥ 64 | ≤ 4 | 8 | ≥ 16 | |
P. mirabilis [1] | NDM-1 | CTX-M-65 | 1 | 8 | 4 | ≥ 16 | ≥ 16 | ≥ 16 | ≥ 16 | ≥ 8 | ≥ 8 | 32 | 16 | 8 | ≥ 32 | ≥ 16 |
P. rettgeri [1] | IMP-1 | 1 | 16 | 16 | ≥ 16 | ≥ 16 | ≥ 16 | ≥ 16 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | 8 | 16 | 2 | |
S. marcescens [3] | GES-5 | 1 | 8 | > 16 | 8 | ≥ 16 | 8 | ≥ 16 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | ≥ 128 | 8 | 2 | |
IMP-1 | 2 | 16 to > 16 | 16 to > 16 | 8 to ≥ 16 | ≥ 16 | ≥ 16 | ≥ 16 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | 64 to ≥ 128 | 16 to ≥ 32 | ≥ 16 |
Species | β-lactamase content | No. of strains | MICs( μg/mL) of BMD | AST-N404 | AST-N268 | XN-17 | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
ESBLs | PABL | IPM | MEPM | IPM | MEPM | IPM | MEPM | FRPM | ETPM | CFX | LMOX | TAZ/PIPC | CTLZ/TAZ | AVI/CAZ | ||
E. cloacae [2] | C-AmpC | 2 | 2–4 | ≤ 0.5 to 2 | 1 | ≤ 0.25 | 2 | ≤ 0.25 | 2 to 4 | ≤ 0.12 | ≥ 64 | ≤ 4 | ≤ 4 | ≤ 0.25 | ≤ 0.12 to 0.5 | |
E. coli (38) | CTX-M-1 | 4 | ≤ 0.5 | ≤ 0.5 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | ≤ 0.5 to 1 | ≤ 0.12 | ≤ 4 | ≤ 4 | ≤ 4 | ≤ 0.25 to 16 | ≤ 0.12 | |
CTX-M-2 | 4 | ≤ 0.5 | ≤ 0.5 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | ≤ 0.5 to 2 | ≤ 0.12 to 0.25 | ≤ 4 to 16 | ≤ 4 | ≤ 4 to ≥ 128 | 2 to 16 | ≤ 0.12 to 0.5 | ||
CTX-M-9 | 4 | ≤ 0.5 | ≤ 0.5 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | 1 | ≤ 0.12 | ≤ 4 | ≤ 4 | ≤ 4 to 16 | ≤ 0.25 | ≤ 0.12 | ||
SHV-12 | 5 | ≤ 0.5 | ≤ 0.5 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | ≤ 0.5 to 1 | ≤ 0.12 | ≤ 4 to 16 | ≤ 4 | ≤ 4 | ≤ 0.25 | ≤ 0.12 | ||
TEM-20 | 1 | ≤ 0.5 | ≤ 0.5 | 0.5 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | 2 | 0.5 | 8 | 8 | ≥ 128 | 4 | 0.25 | ||
TEM-52 | 1 | ≤ 0.5 | ≤ 0.5 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | 1 | ≤ 0.12 | ≤ 4 | ≤ 4 | ≤ 4 | ≤ 0.25 | ≤ 0.12 | ||
CIT | 8 | ≤ 0.5 | ≤ 0.5 | ≤ 0.25 to 1 | ≤ 0.25 | ≤ 0.25 to 0.5 | ≤ 0.25 | 1 to ≥ 8 | ≤ 0.12 to 0.25 | 32 to ≥ 64 | ≤ 4 to 8 | ≤ 4 to 64 | ≤ 0.25 to 2 | ≤ 0.12 to 0.25 | ||
DHA | 3 | ≤ 0.5 | ≤ 0.5 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | 2 to 4 | ≤ 0.12 | ≥ 64 | ≤ 4 | ≤ 4 to 32 | ≤ 0.25 | ≤ 0.12 | ||
MOX | 1 | ≤ 0.5 | ≤ 0.5 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | ≥ 8 | ≤ 0.12 | ≥ 64 | 32 | 16 | 0.5 | ≤ 0.12 | ||
CTX-M-1 | CIT | 5 | ≤ 0.5 | ≤ 0.5 | ≤ 0.25 to 1 | ≤ 0.25 | ≤ 0.25 to 1 | ≤ 0.25 | ≤ 0.5 to 1 | ≤ 0.12 to 0.25 | ≤ 4 to ≥ 64 | ≤ 4 | ≤ 4 to 16 | ≤ 0.25 to 1 | ≤ 0.12 to 0.25 | |
CTX-M-1,-M-9 | CIT | 1 | ≤ 0.5 | ≤ 0.5 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | 1 | ≤ 0.12 | 16 | ≤ 4 | 8 | 1 | 0.25 | |
CTX-M-2 | CIT | 1 | ≤ 0.5 | ≤ 0.5 | 1 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | 2 | 0.25 | ≥ 64 | ≤ 4 | 8 | 2 | 0.5 | |
CTX-M-9 | CIT | 2 | ≤ 0.5 | ≤ 0.5 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | 2 to 4 | 0.25 | ≥ 64 | ≤ 4 to 16 | 32 to ≥ 128 | 4 to ≥ 32 | ≤ 0.12 to 0.5 | |
CTX-M-9 | DHA | 1 | ≤ 0.5 | ≤ 0.5 | 1 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | 4 | ≤ 0.12 | ≥ 64 | ≤ 4 | ≤ 4 | 4 | 0.25 | |
SHV | CIT | 1 | ≤ 0.5 | ≤ 0.5 | 1 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | 1 | ≤ 0.12 | ≥ 64 | ≤ 4 | 16 | 1 | 0.25 | |
K. aerogenes [3] | C-AmpC | 3 | 2 to 8 | 1 to 4 | 4 | 1 | 2 | ≤ 0.25 to 4 | ≥ 8 | ≤ 0.12 to ≥ 8 | ≥ 64 | ≤ 4 to 32 | ≤ 4 to 32 | ≤ 0.25 to 8 | ≤ 0.12 to 2 | |
K. oxytoca [4] | CIT | 2 | ≤ 0.5 | ≤ 0.5 | ≤ 0.25 to 0.5 | ≤ 0.25 | ≤ 0.25 to 0.5 | ≤ 0.25 | ≤ 0.5 to 1 | ≤ 0.12 | ≤ 4 to 16 | ≤ 4 | ≤ 4 | ≤ 0.25 | ≤ 0.12 | |
DHA | 1 | ≤ 0.5 | ≤ 0.5 | 2 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | ≥ 8 | 1 | ≥ 64 | ≤ 4 | ≥ 128 | 16 | 0.5 | ||
MOX | 1 | ≤ 0.5 | ≤ 0.5 | ≤ 0.25 | ≤ 0.25 | 1 | ≤ 0.25 | ≥ 8 | 0.25 | ≥ 64 | ≥ 64 | 16 | 0.5 | 0.5 | ||
K. pneumoniae [19] | CTX-M-1 | 2 | ≤ 0.5 | ≤ 0.5 | ≤ 0.25 | ≤ 0.25 | 1 | ≤ 0.25 | 1 to 4 | ≤ 0.12 to 0.25 | ≤ 4 | ≤ 4 | 32 to ≥ 128 | 16 to ≥ 32 | 0.5 | |
CTX-M-2 | 1 | ≤ 0.5 | ≤ 0.5 | 0.5 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | 2 | ≤ 0.12 | 8 | ≤ 4 | ≤ 4 | ≤ 0.25 | ≤ 0.12 | ||
CTX-M-9 | 2 | ≤ 0.5 | ≤ 0.5 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | 1 to 4 | ≤ 0.12 | ≤ 4 | ≤ 4 | 8 to ≥ 128 | ≤ 0.25 | ≤ 0.12 | ||
CIT | 3 | ≤ 0.5 | ≤ 0.5 | 2 | ≤ 0.25 | 0.5 to 1 | ≤ 0.25 | ≥ 8 | 0.25 | ≥ 64 | 8 | 8 to ≥ 128 | ≤ 0.25 to 8 | 0.25 to 0.5 | ||
DHA | 8 | ≤ 0.5 to 4 | ≤ 0.5 to 4 | ≤ 0.25 to 2 | ≤ 0.25 to 2 | ≤ 0.25 to 1 | ≤ 0.25 to 4 | ≥ 8 | 0.25 to ≥ 8 | 32 to ≥ 64 | ≤ 4 to ≥ 64 | 32 to ≥ 128 | 4 to ≥ 32 | 0.25 to 8 | ||
MOX | 1 | ≤ 0.5 | ≤ 0.5 | ≤ 0.25 | ≤ 0.25 | 1 | ≤ 0.25 | ≥ 8 | 0.5 | ≥ 64 | ≥ 64 | 16 | 2 | 1 | ||
CTX-M-9 | DHA | 2 | ≤ 0.5 | ≤ 0.5 | ≤ 0.25 to 0.5 | ≤ 0.25 | ≤ 0.25 | ≤ 0.25 | ≥ 8 | 0.25 | ≥ 64 | ≤ 4 | 8 | ≤ 0.25 to 16 | 0.25 to 0.5 | |
P. mirabilis [5] | CTX-M-2 | 3 | ≤ 0.5 to 1 | ≤ 0.5 | 2 to ≥ 16 | 1 | 2 to ≥ 16 | 1 | ≥ 8 | ≤ 0.12 | 8 to 32 | ≤ 4 | ≤ 4 | ≤ 0.25 to 8 | ≤ 0.12 to 0.25 | |
CIT | 1 | ≤ 0.5 | ≤ 0.5 | 8 | 1 | 8 | 0.5 | ≥ 8 | ≤ 0.12 | ≥ 64 | ≤ 4 | ≤ 4 | 8 | ≤ 0.12 | ||
CTX-M-2 | CIT | 1 | ≤ 0.5 | ≤ 0.5 | 4 | ≤ 0.25 | 2 | ≤ 0.25 | ≤ 0.5 | ≤ 0.12 | 32 | 8 | ≤ 4 | 0.5 | ≤ 0.12 | |
S. marcescens [1] | C-AmpC | 1 | 4 | 2 | 1 | 4 | 4 | 4 | ≥ 8 | ≥ 8 | ≥ 64 | ≥ 64 | ≥ 128 | 8 | 2 |
CPE (n = 93) | non-CPE (n = 76) | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Card NO | Antimicrobial | Cut off value | Positive | Indeterminate | Negative | Positive | Indeterminate | Negative | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) |
AST-N404 | IPM | 1 | 47 | 0 | 46 | 12 | 3 | 61 | 50.5 | 83.6 | 79.7 | 57.0 |
MEPM | 1 | 85 | 0 | 8 | 3 | 0 | 73 | 91.4 | 96.2 | 96.6 | 90.1 | |
MEPM | 0.25 | 92 | 0 | 1 | 7 | 0 | 69 | 98.9 | 90.8 | 92.9 | 98.6 | |
AST-N268 | IPM | 1 | 45 | 0 | 48 | 11 | 0 | 65 | 48.4 | 85.5 | 80.4 | 57.5 |
MEPM | 1 | 88 | 0 | 5 | 3 | 0 | 73 | 94.6 | 96.1 | 96.7 | 93.6 | |
MEPM | 0.25 | 92 | 0 | 1 | 8 | 0 | 68 | 98.9 | 89.5 | 92.0 | 98.6 | |
AST-XN17 | FRPM | 2 | 93 | 0 | 0 | 33 | 0 | 43 | 100.0 | 56.6 | 73.8 | 100 |
ETPM | 0.5 | 84 | 0 | 9 | 6 | 0 | 70 | 90.3 | 92.1 | 93.3 | 88.6 | |
CFX | 8 | 92 | 0 | 1 | 50 | 0 | 26 | 98.9 | 34.2 | 64.8 | 96.3 | |
LMOX | 8 | 88 | 0 | 5 | 7 | 0 | 69 | 94.6 | 90.8 | 92.6 | 93.2 | |
TAZ/PIPC | 16 | 60 | 0 | 33 | 20 | 2 | 54 | 64.5 | 73.0 | 75.0 | 62.1 | |
TAZ/CTLZ | 2 | 90 | 0 | 3 | 21 | 2 | 53 | 96.8 | 71.6 | 81.1 | 94.6 | |
AVI/CAZ | 8 | 65 | 0 | 28 | 0 | 2 | 74 | 69.9 | 100.0 | 100 | 72.5 | |
Comments of AES | ||||||||||||
AST-N404 + XN17 | 81 | 13 | 4 | 72 | 86.2 | 94.7 | 95.3 | 84.7 | ||||
AST-N268 + XN17 | 86 | 8 | 7 | 69 | 91.5 | 90.8 | 92.5 | 89.6 |