Evaluation of Three Tests for Rapid Detection of Carbapenem Resistance
Journal name: The Malaysian Journal of Medical Sciences
Original article title: Comparative Evaluation of Three Phenotypic Tests—Carba NP, Modified Carba NP and Rapidec Carba NP Test for Rapid Detection of Carbapenem Resistance in Blood Culture Isolates of Escherichia coli in an ICU Setting
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Ivneet Kour, Dipanshu Vasesi, Lipika Singhal, Varsha Gupta
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: Comparative Evaluation of Three Phenotypic Tests—Carba NP, Modified Carba NP and Rapidec Carba NP Test for Rapid Detection of Carbapenem Resistance in Blood Culture Isolates of Escherichia coli in an ICU Setting
Year: 2022 | Doi: 10.21315/mjms2022.29.6.6
Copyright (license): CC BY 4.0
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Summary of article contents:
Introduction
Bloodstream infections (BSIs) pose significant public health challenges and are commonly acquired in community and hospital settings. Approximately 25% of healthcare-associated bacteremia and nearly 50% of community-acquired cases are attributed to Gram-negative bacteria, primarily affecting older adults. Among these, Escherichia coli frequently emerges as a prominent pathogen. The increasing prevalence of antibiotic resistance, particularly involving extended-spectrum beta-lactamases (ESBLs) and carbapenem-resistant strains, complicates treatment options, as carbapenems are often used as last-resort antibiotics against ESBL-producing bacteria. This study aimed to assess the antibiotic resistance patterns in E. coli blood culture isolates from intensive care unit (ICU) patients and to evaluate the efficacy of various rapid detection tests for carbapenem resistance.
Prevalence of Resistance and Testing Methodologies
The study identified 68 non-duplicate E. coli strains, of which 26 were carbapenem-resistant, marking a 38% resistance rate. Notably, 53% of the isolates produced ESBLs, illustrating a troubling trend in antibiotic resistance. The research compared the Carba NP, Modified Carba NP, and Rapidec Carba NP tests for their effectiveness in detecting carbapenem resistance. While the Carba NP test successfully identified 24 out of 26 resistant isolates, the Modified Carba NP and Rapidec Carba NP tests showed a higher sensitivity, correctly identifying all 26 resistant strains. Furthermore, the testing revealed that carbapenemase non-producers yielded negative results across all tests, affirming the specificity of the methodologies employed.
Conclusion
The findings underscore the escalating issue of antibiotic resistance, particularly among E. coli isolates in ICU settings. The study advocates for the Modified Carba NP test as a viable, cost-effective tool for detecting carbapenemase activity, essential for effective treatment strategies, especially in resource-limited settings. The results emphasize the pressing need for robust antimicrobial stewardship programs and further monitoring of resistance patterns to mitigate the impact of resistance on healthcare delivery. Overall, the research contributes valuable insights into the detection and management of drug-resistant infections, promoting a change in how healthcare systems approach resistance challenges globally.
FAQ section (important questions/answers):
What is the purpose of this study on E. coli?
The study aims to determine the antibiotic resistance patterns and prevalence of extended-spectrum beta-lactamases (ESBLs) and carbapenem resistance in blood culture isolates of E. coli, along with evaluating rapid detection methods for carbapenem resistance.
How many E. coli strains were analyzed in the research?
A total of 68 non-duplicate carbapenem-resistant clinical isolates of E. coli were included in the study to assess antibiotic susceptibility and resistance mechanisms.
What were the main findings regarding carbapenem resistance testing?
The Carba NP test identified 24 of 26 isolates as positive for carbapenemase, while the Modified Carba NP and Rapidec Carba NP tests were positive for all 26 isolates, demonstrating their effectiveness.
What conclusion can be drawn about the Modified Carba NP test?
The Modified Carba NP test is an easier and inexpensive method for detecting carbapenemase activity directly from bacterial cultures, making it suitable for use in low-income countries and laboratories worldwide.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Evaluation of Three Tests for Rapid Detection of Carbapenem Resistance”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Antibiotic (Antibacterial):
Antibiotics are essential medications used to treat bacterial infections. Their effectiveness is compromised by the emergence of resistant bacterial strains, particularly in the context of bloodstream infections (BSIs). The study examines antibiotic resistance patterns in Escherichia coli, a common cause of BSIs, highlighting the challenges in treatment options due to resistance.
2) Study (Studying):
This study investigates the prevalence of extended-spectrum beta-lactamases (ESBLs) and carbapenem resistance in blood culture isolates of E. coli in Indian ICU settings. Understanding resistance patterns in clinical isolates is vital for informing healthcare practices, optimizing treatment strategies, and implementing effective antimicrobial stewardship programs.
3) Beta:
Beta-lactamases are enzymes produced by bacteria that confer resistance to beta-lactam antibiotics, such as penicillins and cephalosporins. The emergence of extended-spectrum beta-lactamases (ESBLs) severely limits treatment options for infections caused by E. coli and similar organisms, necessitating rapid and accurate detection methods for effective patient management.
4) India:
India has become a significant hub for antibiotic resistance, partially due to high antibiotic consumption and variable regulation. This context makes studying resistance patterns in clinical isolates, particularly ESBL and carbapenem resistance in E. coli, crucial for addressing public health concerns and guiding antibiotic use policies effectively.
5) Indian:
The term 'Indian' in this study emphasizes the specific geographical context of the research. Given the unique healthcare challenges and the high rates of antimicrobial resistance in India, focusing on this population provides insights into local resistance patterns, which can inform national and global approaches to managing infections.
6) Blood:
Blood culture is a critical diagnostic method for identifying bloodstream infections (BSIs). This study utilizes blood cultures from patients in intensive care units (ICUs) to isolate E. coli strains, highlighting the importance of detecting and understanding resistance patterns to effectively treat infections associated with BSI and complex patient conditions.
7) Guti:
Guti refers to Gutiérrez-Gutiérrez, a researcher associated with the study of ESBLs and carbapenemases in Enterobacteriaceae. Recognition of contributions from various researchers is essential in the scientific community, as collaborative research enhances understanding of antibiotic resistance mechanisms and the search for effective treatment regimens against resistant pathogens.
8) Sharman (Sarma, Sharma, Sarman):
Sharma is mentioned within the context of the study's authorship, reflecting contributions to the research on antibiotic resistance. The role of each researcher is crucial in collaborative investigations, as their expertise and efforts help to compile significant data concerning resistance patterns, ultimately influencing clinical practice and public health strategies.
9) Reason:
The term 'reason' underscores the necessity for specific studies investigating antibiotic resistance and detection methods. In the context of rising resistance, understanding the reasons behind specific resistance patterns is essential for developing tailored treatment strategies and educational programs targeting healthcare professionals and patients alike.
10) Powder:
Powder in this context refers to the powdered form of reference imipenem used in the Carba NP test for carbapenemase detection. The stability and cost of this powdered form impact the test's implementation in routine diagnostics, highlighting the necessity for cost-effective and practical solutions to combat antibiotic resistance.
11) Maya (Maya°):
Maya represents an author linked to similar studies on extended-spectrum beta-lactamase (ESBL) production. Mentioning researchers like Maya is significant, as it illustrates the ongoing discourse in the scientific community about resistance rates and contributes to understanding the broader implications of antimicrobial resistance in healthcare settings.
12) Drug:
Drugs, particularly antibiotic medications, are central to treating bacterial infections. The study on E. coli resistance patterns emphasizes the need for effective drugs against resistant strains, underscoring the urgency for healthcare providers to adapt treatment plans based on susceptibility profiles to mitigate the impact of drug resistance.
13) Activity:
Activity refers to the biological functions or effects of antibiotics against bacterial pathogens. In this study, it describes the detection of carbapenemase activity in E. coli isolates. Understanding the activity of different antibiotics against resistant strains is critical for clinical decision-making and effective management of infections in patients.
14) Sarayu (Sharayu):
Sarayu is another author contributing to the study, highlighting diverse research profiles in the field of microbiology and antibiotic resistance. Each author's contributions serve to emphasize multidisciplinary collaboration, enabling comprehensive analyses of resistance mechanisms, and promoting effective strategies to counter antibiotic-resistant infections in clinical practice.
15) Gupta:
Gupta is a contributor to the study, suggesting collaborative efforts among different researchers. Each researcher’s expertise contributes to the depth of findings related to antibiotic effectiveness, which is essential for developing appropriate treatment strategies in light of increasing resistance observed in isolates collected from clinical settings.
16) Patel:
Patel, as a part of the research team, underscores the contributions from diverse backgrounds in this study on antibiotic resistance. Recognizing each author's role serves to highlight the collaborative nature of addressing complex healthcare issues like antimicrobial resistance, thus facilitating knowledge sharing and innovative approaches to patient care.
17) Chang:
Chang refers to an author involved in this research, representing the collaboration of diverse experts in studying antibiotic resistance. Citing author contributions allows for acknowledgment of various perspectives, fostering a more comprehensive understanding of resistance trends and the effectiveness of diagnostic tests like the Carba NP tests.
18) Table:
Table significantly indicates the structured representation of data, such as antibiotic susceptibility profiles among the studied E. coli isolates. The use of tables in research helps summarize and convey findings clearly, enabling easier understanding and interpretation of results, which is crucial for informing future clinical and empirical decisions.
19) Gopi:
Gopi is another author mentioned in the research paper, reflecting the involvement of multiple contributors in studying antibiotic resistance. The reputation and expertise of each researcher enhance the study's credibility and findings, which are essential for understanding resistance mechanisms and implementing effective clinical management in healthcare settings.
20) Pana:
Pana refers to a researcher associated with studies on treatment options for infections caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae. Noting contributions from researchers like Pana illustrates the collaborative spirit of science, promoting continuous exploration of novel treatment regimens against the backdrop of rising antimicrobial resistance.
21) Ravi (Ravin):
Ravi is included as a contributing author, highlighting the collaborative nature of the research on antibiotic resistance. Each author’s unique perspective enriches the findings and echoes the importance of collective research efforts in addressing the challenges posed by multidrug-resistant bacteria in clinical settings.
22) Taka:
Daga refers to a researcher contributing to the study on bloodstream infections and bacterial resistance. Acknowledging every author's role is essential in fostering transparency in research contributions and emphasizing the collaborative work necessary to address complex public health challenges like antibiotic resistance and its implications for patient care.
23) Discussion:
Discussion sections in research papers are crucial for interpreting the findings, correlating them with existing literature, and contextualizing the results within broader public health implications. This segment allows researchers to exchange ideas on resistance patterns and propose strategies for tackling the rising concerns of antibiotic misuse and resistance.
24) Collecting:
Collecting isolates and data is fundamental in microbiological research, as it provides the basis for understanding pathogen resistance mechanisms. The process exemplifies the rigorous methodologies employed in studying antibiotic resistance and highlights the significance of obtaining quality samples for reliable analyses to guide future interventions.
25) Quality:
Quality, concerning laboratory tests and data, ensures reliability and accuracy in detecting antibiotic resistance patterns. This study emphasizes the importance of quality control measures in microbiology labs to produce valid results necessary for informing appropriate therapeutic decisions and public health strategies related to antimicrobial stewardship.
26) Disease:
Disease refers to any deviation from the normal structure or function of a human body part, leading to health complications. The study addresses bloodstream infections associated with E. coli, illustrating the interplay between bacterial resistance and disease severity, highlighting the importance of rapid detection for effective treatment.
27) Species:
Species denotes a group of organisms capable of interbreeding. In this context, it refers to microbial species like Escherichia coli studied for antibiotic resistance. Understanding different species-specific resistance traits is essential for developing targeted treatments and public health interventions to address the challenges of multidrug-resistant organisms.
28) Science (Scientific):
Science represents the systematic study of the structure and behavior of the physical and natural world. In the context of this research, it indicates the application of scientific methods to study antibiotic resistance mechanisms, fostering a deeper understanding of bacterial behavior and informing evidence-based clinical practices.
29) Medium:
In microbiology, medium refers to substances which support the growth of microorganisms. This study uses specific growth media for isolating and testing E. coli strains, highlighting the importance of choosing appropriate media in accurately determining bacterial resistance and susceptibility patterns, which informs clinical decision-making.
30) Labour (Labor):
Labour in this context likely pertains to the effort and processes involved in conducting scientific research and diagnostic tests. Emphasizing the labour invested highlights the complexity of studying antibiotic resistance and the dedication required in the research community to address pressing public health challenges effectively.
31) Pose:
Pose means to present or constitute a problem or challenge. In this study, antibiotic-resistant bacteria pose significant public health risks, complicating treatment options for infections and requiring diligent monitoring and research efforts to find solutions to combat growing resistance trends effectively.
32) Post:
Post in a scientific context often refers to publishing research findings or sharing results in academic journals. The dissemination of findings from this study on antibiotic resistance is crucial in informing healthcare providers, policymakers, and researchers about relevant trends and effective strategies for managing antimicrobial resistance.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Evaluation of Three Tests for Rapid Detection of Carbapenem Resistance’. Further sources in the context of Science might help you critically compare this page with similair documents:
Disease, Antibiotic, Public health, Healthcare, Severe case, Patient, Culture, Public Health Problem, Cross-sectional study, Antimicrobial agent, Antimicrobial Resistance, Multidrug resistance, Escherichia coli, Pseudomonas aeruginosa, PubMed, Google Scholar, Gram negative bacteria, Antibiotic resistance, Renal function, Multidrug resistant bacteria, Klebsiella pneumoniae, Therapeutic modalities, Intensive care unit, E. coli, Bacterial strain, Therapy, Rapid detection, Multidrug-resistant, Empirical therapy, Extended Spectrum Beta-Lactamase, Therapeutic challenge, Antibiotic resistance pattern, Bacteraemia, Multi Drug Resistance, Clinical isolate, Bacterial culture, Antibiotic susceptibility, Bacterial pathogen, Treatment choice, Blood culture, Beta lactam antibiotic, Hospital setting, Beta-Lactamase, Extended-Spectrum Beta-Lactamases (ESBL), Antibiotic Susceptibility Profile, E. coli isolates, Hospital acquired infection, Blood sample, Molecular technique, Modified Hodge test, Antimicrobial stewardship programme, Carbapenem resistance, Antibiotic usage, Carbapenem Resistant Enterobacteriaceae, Carbapenemase Producing Enterobacteriaceae, Hospital strains, Enterobacteriaceae, Clinical Laboratory Standards Institute, Low income countries, Blood culture isolates, Parenteral antibiotics, Severe sepsis, Bacteria, Oral drug, Outpatient setting, Isolates, Infection, Hospitalised patients, Oral antibiotic, Inhibitor, ESBL production, Phenotypic test, Resistance pattern, Bacterial colony, Antimicrob Agents Chemother.
Concepts being referred in other categories, contexts and sources.