Phenotypic detection of metallo-β-lactamase in imipenem-resistant Pseudomonas aeruginosa

ScientificWorldJournal. 2012:2012:654939. doi: 10.1100/2012/654939. Epub 2012 Jun 18.

Abstract

Carbapenems are the primary choice of treatment for severe Pseudomonas aeruginosa infection. However, the emergence of carbapenem resistance due to the production of metallo-β-lactamases (MBLs) is of global concern. In this study, 90 imipenem- (IPM- or IP-) resistant P. aeruginosa (IRPA) isolates, including 32 previously tested positive and genotyped for MBL genes by PCR, were subjected to double-disk synergy test (DDST), combined disk test (CDT), and imipenem/imipenem-inhibitor (IP/IPI) E-test to evaluate their MBLs detection capability. All three methods were shown to have a sensitivity of 100%. However, DDST was the most specific of the three (96.6%), followed by IP/IPI E-test interpreted based on the single criteria of IP/IPI ≥8 as positive (62.1%), and CDT was the least specific (43.1%). Based on the data from this evaluation, we propose that only IRPA with IP MIC >16 μg/mL and IP/IPI ≥8 by IP/IPI E-test should be taken as positive for MBL activity. With the new dual interpretation criteria, the MBL IP/IPI E-test was shown to achieve 100% sensitivity as well as specificity for the IRPA in this study. Therefore, the IP/IPI E-test is a viable alternative phenotypic assay to detect MBL production in IRPA in our population in circumstances where PCR detection is not a feasible option.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Drug Resistance, Bacterial / genetics*
  • False Positive Reactions
  • Genotyping Techniques*
  • Humans
  • Imipenem / pharmacology*
  • Microbial Sensitivity Tests
  • Phenotype
  • Pseudomonas aeruginosa / drug effects*
  • Pseudomonas aeruginosa / enzymology*
  • Sensitivity and Specificity
  • beta-Lactamases / genetics*
  • beta-Lactamases / isolation & purification*

Substances

  • Anti-Bacterial Agents
  • Imipenem
  • metallo-beta-lactamase (VIM-13), Pseudomonas aeruginosa
  • beta-Lactamases