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Emerg Infect Dis. 2016 Jun;22(6):1038-43. doi: 10.3201/eid2206.151840.

Rapid Detection of Polymyxin Resistance in Enterobacteriaceae.

Abstract

For identification of polymyxin resistance in Enterobacteriaceae, we developed a rapid test that detects glucose metabolization associated with bacterial growth in the presence of a defined concentration of colistin or polymyxin B. Formation of acid metabolites is evidenced by a color change (orange to yellow) of a pH indicator (red phenol). To evaluate the test, we used bacterial colonies of 135 isolates expressing various mechanisms of colistin resistance (intrinsic, chromosomally encoded, and plasmid-mediated MCR-1) and 65 colistin-susceptible isolates. Sensitivity and specificity were 99.3% and 95.4%, respectively, compared with the standard broth microdilution method. This new test is inexpensive, easy to perform, sensitive, specific, and can be completed in <2 hours. It could be useful in countries facing endemic spread of carbapenemase producers and for which polymyxins are last-resort drugs.

KEYWORDS:

Enterobacteriaceae; MCR-1; antibiotic; antimicrobial resistance; colistin; polymyxin B; rapid diagnostic test; resistance; susceptibility testing

PMID:
27191712
PMCID:
PMC4880072
DOI:
10.3201/eid2206.151840
[Indexed for MEDLINE]
Free PMC Article

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