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2017, Cilt 47, Sayı 2, Sayfa(lar) 078-082
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Use of Carbapenemase Inactivation Test in the Detection of Carbapenemase Production Among The Isolates of Carbapenem- Resistant Klebsiella pneumoniae
Tayfun DEMİRAY1, Özlem AYDEMİR1, Ümit KILIÇ2, Kerem YILMAZ2, Mehmet KÖROĞLU2, Mustafa ALTINDİŞ2
1Sakarya Üniversitesi, Eğitim ve Araştırma Hastanesi, Klinik Mikrobiyoloji Laboratuvarı, Sakarya
2Sakarya Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Ana Bilim Dalı, Sakarya
Keywords: Carbapenemase inactivation test, carbapenemases, Klebsiella pneumoniae

Objective: The infections caused by carbapenemaseproducing Enterobacteriaceae isolates are among the most actual health problems in our country as well as all over the world. Epidemics and sporadic cases caused by carbapenem- resistant Klebsiella species have begun to be reported increasingly from our country. In this study, we aimed to compare the diagnostic value of carbapenemase inactivation test with the modified Hodge test in carbapenemase producing K. pneumoniae isolates verified by molecular method and to evaluate the use of this test in routine laboratory practice.

Material and Methods: A total of 125 isolates of Klebsiella pneumoniae harvested from clinical, and screening specimens between 2014 and 2015 were evaluated. Carbapenemase-producing 60, and carbapenem sensitive 60 isolates were used for the evaluation of the modified Hodge test and carbapenemase inactivation test. Molecular evaluation was performed by investigating the blaIMP-1, blaKPC, blaNDM-1, blaOXA-48 and blaVIM gene regions with Carba R kits (Cepheid, USA) of the Gene-Xpert® system.

Results: The modified Hodge test detected 54 out of 60 Klebsiella isolates, which were found to have carbapenemase encoding gene by molecular method; whereas carbapenemase inactivation test detected 52 out of 60 isolates.

Conclusion: When molecular method is regarded as gold standard, sensitivities of modified Hodge test and carbapenemase inactivation test were 0.85 and 0.80; specificities were calculated as 0.95 and 0.93, respectively. Phenotypic tests depending on enzyme inhibition can be preferred in routine practice since they have low cost and are easy-to-apply. However, it should not be forgotten that the sensitivity and specificity of these tests are variable.


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