Application of Molecular Diagnostics in Primary Detection of ESBL Directly from Clinical Specimens

Microb Drug Resist. 2015 Jun;21(3):352-7. doi: 10.1089/mdr.2014.0210. Epub 2015 Jan 14.

Abstract

The infections caused by extended-spectrum β-lactamase (ESBL)-producing organisms are associated with increased mortality. The real-time polymerase chain reaction (PCR) method, which enables detection of ESBLs directly from patients' clinical material, was developed. This study focused on blaCTX-M and blaSHV determination in endotracheal aspirates. Each sample was identified with standard microbiological procedures and simultaneously analyzed for the presence of nucleic acids, which encode CTX-M and SHV ESBL enzymes using real-time PCR. A total of 341 samples were investigated. In the set, 27 ESBL-positive samples were identified by phenotypic methods, while 60 positive samples were identified by the PCR method. Of the 60 PCR-positive samples, 58 were positive for the blaCTX-M. In two samples, the ESBL blaSHV-ESBL gene was detected. One phenotypically positive sample was PCR negative. The real-time PCR assay does not require a cultivation step and therefore enables detection of ESBL in 6 hours. The rapid method is necessary for early and adequate antimicrobial treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Enterobacteriaceae / drug effects
  • Enterobacteriaceae / genetics*
  • Enterobacteriaceae / isolation & purification
  • Enterobacteriaceae Infections / diagnosis*
  • Enterobacteriaceae Infections / drug therapy
  • Enterobacteriaceae Infections / microbiology
  • Gene Expression
  • Humans
  • Microbial Sensitivity Tests
  • Plasmids / chemistry
  • Plasmids / metabolism
  • Real-Time Polymerase Chain Reaction / methods*
  • Respiratory Tract Infections / diagnosis*
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / microbiology
  • Retrospective Studies
  • beta-Lactam Resistance / genetics*
  • beta-Lactamases / genetics*
  • beta-Lactamases / metabolism

Substances

  • Anti-Bacterial Agents
  • beta-Lactamases