A simple test for the detection of KPC and metallo-β-lactamase carbapenemase-producing Pseudomonas aeruginosa isolates with the use of meropenem disks supplemented with aminophenylboronic acid, dipicolinic acid and cloxacillin

Clin Microbiol Infect. 2011 Sep;17(9):1438-41. doi: 10.1111/j.1469-0691.2011.03585.x. Epub 2011 Jun 20.

Abstract

We evaluated the ability of the combination disk test (CDT) and the Modified Hodge Test (MHT) to discriminate between various carbapenemase-producing Pseudomonas aeruginosa isolates (KPC, n = 36; metallo-β-lactamase (MBL), n = 38) and carbapenemase non-producers (n = 75). For the CDT, the optimal inhibitor concentrations and cut-off values were: 600 μg of 3-aminophenylboronic acid (APB) per disk (an increment of ≥4 mm), 1000 μg of dipicolinic acid (DPA) per disk (an increment of ≥5 mm) and 3000 μg of cloxacillin per disk (an increment of ≥3 mm). APB had excellent sensitivity (97%) and specificity (97%) for the detection of KPC enzymes. DPA detected MBL enzymes with a sensitivity and specificity of 97% and 81%, respectively. The MHT resulted in a low sensitivity (78%) and specificity (57%). The CDT could be very useful in daily practice to provide fast and reliable detection of KPC and MBL carbapenemases among P. aeruginosa isolates.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Bacterial Proteins / drug effects
  • Bacterial Proteins / metabolism*
  • Boronic Acids / pharmacology
  • Cloxacillin / pharmacology
  • Disk Diffusion Antimicrobial Tests / methods*
  • Humans
  • Meropenem
  • Picolinic Acids / pharmacology
  • Pseudomonas Infections / microbiology
  • Pseudomonas aeruginosa / classification
  • Pseudomonas aeruginosa / drug effects
  • Pseudomonas aeruginosa / enzymology*
  • Sensitivity and Specificity
  • Thienamycins / pharmacology*
  • beta-Lactamases / drug effects
  • beta-Lactamases / metabolism*

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Boronic Acids
  • Picolinic Acids
  • Thienamycins
  • 3-aminobenzeneboronic acid
  • beta-Lactamases
  • carbapenemase
  • Meropenem
  • Cloxacillin
  • dipicolinic acid