scholarly journals Evaluation of the BD Phoenix CPO detect panel for prediction of Ambler class carbapenemases

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Daniel Jonas ◽  
Sandra Reuter ◽  
Sarah Klassen ◽  
Sabine Weber ◽  
Marion Buck ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Rapid Detection ◽  
Beta Lactamases ◽  
Class A ◽  
Class D ◽  
Carbapenemase Gene ◽  
False Positive Detection ◽  
Class B ◽  
Confirmatory Tests

AbstractRapid detection of carbapenemases as a cause of resistance is beneficial for infection control and antimicrobial therapy. The BD Phoenix NMIC-502 panel and CPO detect test identifies presence of carbapenemases in Enterobacterales such as Klebsiella pneumoniae and assigns them to Ambler classes. To evaluate the performance of the CPO detect panel, we employed a European collection of 1222 K. pneumoniae including carbapenem non-susceptible and susceptible clinical isolates from 26 countries, for which draft genomes were available after Illumina sequencing and the presence of carbapenemase genes had been identified by ARIBA gene calling. The CPO panel detected 488 out of 494 carbapenemase-encoding isolates as positive and six as negative. One-hundred and two isolates were tested positive for carbapenemase in the absence of any carbapenemase gene. The CPO panel identified 229 out of 230 KPC-positive isolates as carbapenemase producing and classified 62 of these as class A enzyme. Similarly, the CPO panel correctly specified 167 of 182 as class D. Regarding metallo-beta-lactamases, the CPO panel assigned 78 of 90 MBL positive isolates to class B enzymes. The sensitivity of the CPO panel in detecting carbapenemase activity was 99.5%, 97.7% and 98.3% for class A, B and D enzymes, respectively. The sensitivity in assignation to Ambler class A, B and D was 27%, 86% and 91%, respectively. An overall sensitivity of 98.8% and specificity of 86% in unclassified detection of carbapenemases was observed, with frequent false positive detection of carbapenemase producing organisms, thus rendering further confirmatory tests necessary.

scholarly journals Systematic comparison of three commercially available combination disc tests and zCIM for carbapenemase detection in Enterobacterales isolates

2021 ◽  
Author(s):  
Janko Sattler ◽  
Anne Brunke ◽  
Axel Hamprecht
Keyword(s):  
Infection Control ◽  
Patient Treatment ◽  
Diagnostic Strategy ◽  
Class A ◽  
Molecular Tests ◽  
Class D ◽  
Great Performance ◽  
Class B ◽  
Overall Performance ◽  
Sensitivity Specificity

Detection of carbapenemases in Enterobacterales is crucial for patient treatment and infection control. Among others, combination disk tests (CDT) with different inhibitors (e.g. EDTA) and variations of the carbapenem inactivation method (CIM) are recommended by EUCAST or CLSI and are used by many laboratories as they are relatively inexpensive. In this study, we compare three commercially available CDT, faropenem disc testing (FAR) and the zinc supplemented CIM test (zCIM) for detection of carbapenemase-producing Enterobacterales (CPE). Rosco KPC/MBL and OXA-48 Confirm Kit (ROS-CDT), Liofilchem KPC&MBL&OXA-48 disc kit (LIO-CDT), Mastdiscs Combi Carba plus (MAST-CDT), FAR and zCIM were challenged with 106 molecularly characterized CPE and 47 non-CPE. Sensitivity/specificity was 86% (CI 78-92%)/98% (CI 89-100%) for MAST-CDT and ROS-CDT, 96% (CI 91-99%)/87% (CI 74-95%) for LIO-CDT and 99% (CI 95-100%)/81% (CI 67-91%) for FAR compared to 98% (CI 93-100%)/100% (CI 92-100%) for zCIM. The CDT showed great performance differences depending on the carbapenemase class, with MAST-CDT and LIO-CDT best detecting class B, ROS-CDT class A and LIO-CDT class D carbapenemases. Conclusion : The overall performance of commercially available CDTs was good but varied greatly for different carbapenemases and between manufacturers, compared with FAR and zCIM which performed well for all carbapenemase types. For reliable carbapenemase detection CDT should preferably not be used as the sole test, but can be part of a diagnostic strategy when combined with other assays (e.g. CIM-based, immunochromatographic or molecular tests).

scholarly journals Carbapenemases: the Versatile β-Lactamases

2007 ◽  
Vol 20 (3) ◽  
pp. 440-458 ◽  
Author(s):  
Anne Marie Queenan ◽  
Karen Bush
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Klebsiella Pneumoniae ◽  
Acinetobacter Baumannii ◽  
Active Site ◽  
Pathogenic Bacteria ◽  
Class A ◽  
Class D ◽  
Serious Infections ◽  
Class B ◽  
Hydrolytic Mechanism

SUMMARY Carbapenemases are β-lactamases with versatile hydrolytic capacities. They have the ability to hydrolyze penicillins, cephalosporins, monobactams, and carbapenems. Bacteria producing these β-lactamases may cause serious infections in which the carbapenemase activity renders many β-lactams ineffective. Carbapenemases are members of the molecular class A, B, and D β-lactamases. Class A and D enzymes have a serine-based hydrolytic mechanism, while class B enzymes are metallo-β-lactamases that contain zinc in the active site. The class A carbapenemase group includes members of the SME, IMI, NMC, GES, and KPC families. Of these, the KPC carbapenemases are the most prevalent, found mostly on plasmids in Klebsiella pneumoniae. The class D carbapenemases consist of OXA-type β-lactamases frequently detected in Acinetobacter baumannii. The metallo-β-lactamases belong to the IMP, VIM, SPM, GIM, and SIM families and have been detected primarily in Pseudomonas aeruginosa; however, there are increasing numbers of reports worldwide of this group of β-lactamases in the Enterobacteriaceae. This review updates the characteristics, epidemiology, and detection of the carbapenemases found in pathogenic bacteria.

scholarly journals In vitro cost-effective methods to detect carbapenemases in Enterobacteriaceae

2018 ◽  
Vol 10 (01) ◽  
pp. 101-105
Author(s):  
Varsha Gupta ◽  
Ranu Soni ◽  
Neha Jain ◽  
Jagdish Chander
Keyword(s):  
Scientific Community ◽  
Treatment Options ◽  
Cost Effective ◽  
Beta Lactamases ◽  
Therapeutic Modalities ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
Class A ◽  
Class D ◽  
Class B

AbstractThe rise in carbapenemases-producing organisms has challenged the scientific community. Infections caused by these bacteria have limited treatment options. There are various types such as Klebsiella pneumoniae carbapenemase (Ambler class A), metallo-beta-lactamases of VIM-type, IMP-type, NDM-type (Ambler class B), and OXA-48-types (Ambler class D). An efficient strategy for detection of carbapenemase producers is important to determine the appropriate therapeutic modalities. In this study, four methods - Carba NP test, modified Carba NP (MCNP) test, carbapenem inactivation method (CIM) test, and Rapidec Carba NP kit test were evaluated. We evaluated an in-house MCNP test to detect carbapenemase production using a single protocol which gave reliable results. Furthermore, CIM using routine antibiotic discs gives good results. Both these tests were found to be cost-effective.

scholarly journals NitroSpeed-Carba NP Test for Rapid Detection and Differentiation between Different Classes of Carbapenemases in Enterobacterales

2020 ◽  
Vol 58 (9) ◽  
Author(s):  
Patrice Nordmann ◽  
Mustafa Sadek ◽  
Anthony Demord ◽  
Laurent Poirel
Keyword(s):  
Sensitivity And Specificity ◽  
Rapid Detection ◽  
Dipicolinic Acid ◽  
Turnaround Time ◽  
Class A ◽  
Class D ◽  
Different Types ◽  
Class B ◽  
Clinically Significant ◽  
Lactamase Inhibitor

ABSTRACT A biochemical test (NitroSpeed-Carba NP test) was developed to identify carbapenemase production in Enterobacterales and to discriminate between the different types of clinically significant carbapenemases (Ambler classes A, B, and D). It is based on two main features, namely, the hydrolysis by all β-lactamases, including carbapenemases of the nitrocefin substrate, and the capacity of ertapenem to prevent this hydrolysis for all β-lactamases except carbapenemases. Specific carbapenemase inhibitors of class A (avibactam, vaborbactam), class B (dipicolinic acid), and class D (avibactam) were used to inhibit the nitrocefin hydrolysis and to allow the identification of the carbapenemase types with a turnaround time of ca. 30 min. The test was evaluated with a collection of 248 clinical enterobacterial isolates, including 148 carbapenemase producers and 100 non-carbapenemase producers. Its overall sensitivity and specificity were 100% and 97%, respectively, including detection of all types of OXA-48-like carbapenemases. For the detection of the carbapenemase type, including strains that produce double carbapenemases, the sensitivity was 100%, 97%, and 100% for the detection of classes A, B, and D, respectively. This easy-to-implement test may contribute to optimization of the choice of the β-lactam/β-lactamase inhibitor combinations for treating infection due to carbapenemase producers.

scholarly journals Genetic Diversity, Biochemical Properties, and Detection Methods of Minor Carbapenemases in Enterobacterales

2021 ◽  
Vol 7 ◽  
Author(s):  
Rémy A. Bonnin ◽  
Agnès B. Jousset ◽  
Cécile Emeraud ◽  
Saoussen Oueslati ◽  
Laurent Dortet ◽  
...  
Keyword(s):  
Genetic Diversity ◽  
Multidrug Resistant ◽  
Biochemical Properties ◽  
Amino Acid Sequences ◽  
Detection Methods ◽  
Gram Negative ◽  
Class A ◽  
Class D ◽  
Class B ◽  
Encoding Genes

Gram-negative bacteria, especially Enterobacterales, have emerged as major players in antimicrobial resistance worldwide. Resistance may affect all major classes of anti-gram-negative agents, becoming multidrug resistant or even pan-drug resistant. Currently, β-lactamase-mediated resistance does not spare even the most powerful β-lactams (carbapenems), whose activity is challenged by carbapenemases. The dissemination of carbapenemases-encoding genes among Enterobacterales is a matter of concern, given the importance of carbapenems to treat nosocomial infections. Based on their amino acid sequences, carbapenemases are grouped into three major classes. Classes A and D use an active-site serine to catalyze hydrolysis, while class B (MBLs) require one or two zinc ions for their activity. The most important and clinically relevant carbapenemases are KPC, IMP/VIM/NDM, and OXA-48. However, several carbapenemases belonging to the different classes are less frequently detected. They correspond to class A (SME-, Nmc-A/IMI-, SFC-, GES-, BIC-like…), to class B (GIM, TMB, LMB…), class C (CMY-10 and ACT-28), and to class D (OXA-372). This review will address the genetic diversity, biochemical properties, and detection methods of minor acquired carbapenemases in Enterobacterales.

Endolymphatic SAC Surgery for Menière's Disease

1983 ◽  
Vol 92 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Gershon J. Spector ◽  
Peter G. Smith
Keyword(s):  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Class A ◽  
Class D ◽  
Class B ◽  
Ménière's Disease

An endolymphatic-mastoid Silastic shunt procedure was performed in 122 cases of Menière's disease having a mean follow-up period of three years. In accordance with American Academy of Ophthalmology and Otolaryngology 1972 criteria, there were 43 % class A, 20% class B, 21% class C, and 17% class D results. Analysis of 35 recent cases having a mean follow-up period of nine months revealed 57% class A, 25% class B, 9% class C, and 9% class D results. Sixteen percent of the patients who experienced classes A, B or C results complained of other fluctuating symptoms which were not relieved by surgery. Moreover, three new eases of otolithic crisis were found in the postoperative group. Seven of ten patients who experienced a class A or B result had either a recrudescence of their vertigo or a significant decrement in hearing in response to a postoperative salt-loading test. It is concluded that the surgical success rate decreases with time and that the procedure appears to alter the symptom complex but does not cure Menière's disease.

scholarly journals Interactions of Ceftobiprole with β-Lactamases from Molecular Classes A to D

2007 ◽  
Vol 51 (9) ◽  
pp. 3089-3095 ◽  
Author(s):  
Anne Marie Queenan ◽  
Wenchi Shang ◽  
Malgosia Kania ◽  
Malcolm G. P. Page ◽  
Karen Bush
Keyword(s):  
Functional Groups ◽  
Hydrolytic Stability ◽  
Enterobacter Cloacae ◽  
Class A ◽  
Extended Spectrum ◽  
Class D ◽  
The Family ◽  
Class B ◽  
The Common ◽  
Antibacterial Spectrum

ABSTRACT The interactions of ceftobiprole with purified β-lactamases from molecular classes A, B, C, and D were determined and compared with those of benzylpenicillin, cephaloridine, cefepime, and ceftazidime. Enzymes were selected from functional groups 1, 2a, 2b, 2be, 2d, 2e, and 3 to represent β-lactamases from organisms within the antibacterial spectrum of ceftobiprole. Ceftobiprole was refractory to hydrolysis by the common staphylococcal PC1 β-lactamase, the class A TEM-1 β-lactamase, and the class C AmpC β-lactamase but was labile to hydrolysis by class B, class D, and class A extended-spectrum β-lactamases. Cefepime and ceftazidime followed similar patterns. In most cases, the hydrolytic stability of a substrate correlated with the MIC for the producing organism. Ceftobiprole and cefepime generally had lower MICs than ceftazidime for AmpC-producing organisms, particularly AmpC-overexpressing Enterobacter cloacae organisms. However, all three cephalosporins were hydrolyzed very slowly by AmpC cephalosporinases, suggesting that factors other than β-lactamase stability contribute to lower ceftobiprole and cefepime MICs against many members of the family Enterobacteriaceae.

scholarly journals Primary structure of OXA-3 and phylogeny of oxacillin-hydrolyzing class D beta-lactamases.

1995 ◽  
Vol 39 (4) ◽  
pp. 887-893 ◽  
Author(s):  
F Sanschagrin ◽  
F Couture ◽  
R C Levesque
Keyword(s):  
Amino Acids ◽  
Structure And Function ◽  
Amino Acid Sequences ◽  
Specific Class ◽  
Conserved Motifs ◽  
Beta Lactamases ◽  
Class A ◽  
Class D ◽  
And Function ◽  
Conserved Amino Acids

We determined the nucleotide sequence of the blaOXA-3(pMG25) gene from Pseudomonas aeruginosa. The bla structural gene encoded a protein of 275 amino acids representing one monomer of 31,879 Da for the OXA-3 enzyme. Comparisons between the OXA-3 nucleotide and amino acid sequences and those of class A, B, C, and D beta-lactamases were performed. An alignment of the eight known class D beta-lactamases including OXA-3 demonstrated the presence of conserved amino acids. In addition, conserved motifs composed of identical amino acids typical of penicillin-recognizing proteins and specific class D motifs were identified. These conserved motifs were considered for possible roles in the structure and function of oxacillinases. On the basis of the alignment and identity scores, a dendrogram was constructed. The phylogenetic data obtained revealed five groups of class D beta-lactamases with large evolutionary distances between each group.

scholarly journals In Vitro Activity of Cefiderocol against Multi-Drug Resistant Carbapenemase-Producing Gram-Negative Pathogens

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S376-S376 ◽  
Author(s):  
Sandra Boyd ◽  
Karen Anderson ◽  
Valerie Albrecht ◽  
Davina Campbell ◽  
Maria S Karlsson ◽  
...  
Keyword(s):  
Vitro Activity ◽  
Burkholderia Cepacia Complex ◽  
Uptake System ◽  
Drug Resistant ◽  
In Vitro Activity ◽  
Gram Negative ◽  
Class A ◽  
Class D ◽  
Class B

Abstract Background Few options remain for treatment of infections caused by multi-drug resistant (MDR), carbapenemase-producing gram-negative pathogens. Cefiderocol (CFDC; Shionogi & Co. Ltd), is a novel parenteral siderophore cephalosporin that enters the bacterial cell through the iron–siderophore uptake system. Here we report on the in vitro activity of CFDC against a set of well-characterized MDR gram-negative isolates collected by the Centers for Disease Control and Prevention. Methods Minimum inhibitory concentrations (MIC) values for CFDC in iron-depleted cation-adjusted Mueller Hinton broth were determined using reference broth microdilution. Study isolates (n = 315) included Enterobacteriaceae (59%), Pseudomonas aeruginosa (19%), Acinetobacter baumannii (17%), Stenotrophomonas maltophilia (4%), and Burkholderia cepacia complex (1%). Of these, 229 (73%) were carbapenemase-producers including Ambler Class A- (37%), Class B- (29%) and Class D- type (29%) enzymes. The remaining isolates included 51 β-lactam-resistant isolates that were non-carbapenemase-producers, and 35 β-lactam-susceptible isolates. Results were interpreted using suggested CFDC breakpoints of Sensitive ≤4 μg/mL and Resistant ≥16 μg/mL. Results The majority of the isolates (90.8%) were categorized as CFDC susceptible; the percentage of isolates with a CFDC MIC ≤4 μg/mL among Enterobacteriaceae, P. aeruginosa, and A. baumannii was 87.5%, 100%, and 89%, respectively. Percentage of isolates with a CFDC MIC ≤4 μg/mL that harbored a carbapenemase of the Class A-, Class B-, and Class D-type was 91.8%, 74.8%, 98.0%, respectively. By applying suggested breakpoints, 12 isolates were categorized as intermediate and 17 as resistant. The resistant isolates included 11 NDM-, 2 OXA-23- and 4 KPC-positive organisms. Conclusion Cefiderocol showed potent activity against MDR gram-negative pathogens including Class A, B, and D carbapenemase-producing isolates. Of note, all P. aeruginosa, including Class B metallo-β-lactamase producers, were susceptible to CFDC. Disclosures All authors: No reported disclosures.

scholarly journals Selection of medications in comorbidity

2020 ◽  
Vol 10 (1) ◽  
pp. 57-60
Author(s):  
F. I. Belialov
Keyword(s):  
Adverse Effects ◽  
Positive Influence ◽  
Comorbid Disease ◽  
New Classification ◽  
Drug Classification ◽  
Class A ◽  
Class D ◽  
Class B ◽  
Comorbid Diseases ◽  
Selection Of

New classification divides medications on five classes by influence on comorbid diseases and conditions and rates drug’s effects as favourable (A), possible (B), neutral (C), undesirable (D), and unfavourable (X). Class A includes drugs used in treatment of comorbid disease, class B embraced drugs with positive influence, class C includes drugs without significant influence or contradictory influence, class D consist of drugs with possible nonsevere adverse effects, and class X includes drugs with severe adverse effects. The more universal drug classification according to influence on comorbid diseases can include and unite other classifications. Classification may help unify marks of positive and negative influences drugs on comorbidity and help practitioners in selection of effective and safe treatment.

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