SavedAdd your journal

Journals / Mikrobiyoloji Bülteni / 2012 / Cilt: 46 - Sayı: 1

Evaluation of the chromıd esbl agar for the detection of ESBL-positive Enterobacteriaceae and vancomycin-resistant enterococcus ısolates from urine cultures

GSBL pozitif enterobacteriaceae ve vankomisine dirençli enterokokların idrar kültürlerinden erken tespitinde chromıd esbl agarın değerlendirilmesi

HİKMET EDA ALIŞKAN
Şule ÇOLAKOĞLU
Tuba TURUNÇ
YUSUF ZİYA DEMİROĞLU
Pages
17–25
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

As a result, it was concluded that ChromID ESBL agar medium was advantageous since it led to the growth of VRE and ESBL-positive Enterobacteriaceae isolates in different colors and helped in early identification of these two problematic bacteria.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae strains are frequent causative agents both in community-acquired infections and in nosocomial infections.
📊
Key Findings & Data:The aim of this study was to evaluate the performance of ChromID ESBL agar in the rapid identification of ESBL-positive pathogens from the urine samples of the patients with urinary tract infections.
💡
Conclusion & Impact:As a result, it was concluded that ChromID ESBL agar medium was advantageous since it led to the growth of VRE and ESBL-positive Enterobacteriaceae isolates in different colors and helped in early identification of these two problematic bacteria.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Agar · beta-Laktamazlar · Kültür ortamı

Abstract

Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae strains are frequent causative agents both in community-acquired infections and in nosocomial infections. The newly developed ChromID ESBL agar (bioMerieux, Marcy I'Etoile, France) is a chromogenic medium that helps rapid identification of ESBL-positive Enterobacteriaceae species from the clinical samples. The aim of this study was to evaluate the performance of ChromID ESBL agar in the rapid identification of ESBL-positive pathogens from the urine samples of the patients with urinary tract infections. A total of 672 urine samples (437 outpatients, 235 inpatients) were included in the study. All of the samples were inoculated simultaneously to 5% sheep blood agar, McConkey agar and ChromID ESBL agar media, and evaluated after incubation at 37°C for 18-24 hours. Gram-negative pathogens were tested for ESBL both by the standard combined double-disk diffusion (CDD) method using ceftazidime and cefotaxime disks and by doubledisk synergy (DDS) test. Among 672 urine cultures, 199 yielded microbial growth in routine media (sheep blood agar and/or McConkey agar), whereas 57 yielded bacterial growth in ChromID ESBL agar. When CDD method was accepted as the reference method according to Clinical and Laboratory Standards Institute (CLSI) recommendations, the sensitivity, specificity, positive and negative predictive values for ChromID ESBL agar for the detection of ESBL-positive bacteria in urinary tract infections were estimated as 97%, 92.9%, 89.1%, and 98.1%, respectively. Additionally, we also discovered that Chrom ID ESBL agar could detect vancomycin-resistant enterococci (VRE) as well as ESBL-positive bacteria, in our study. In order to investigate this observation we inoculated a total of 203 stock strains of Enterococcus spp. (118 vancomycin-sensitive, 85 vancomycin-resistant) to this medium. None of the vancomycinsensitive Enterococcus spp. did grow in ChromID ESBL medium, while 83 of the 85 resistant isolates (97.6%) did grow in the medium. As a result, it was concluded that ChromID ESBL agar medium was advantageous since it led to the growth of VRE and ESBL-positive Enterobacteriaceae isolates in different colors and helped in early identification of these two problematic bacteria. We thought that especially early detection of VRE will accelerate the establishment of necessary measures to prevent the nosocomial spread of this microorganism.

Özet

Son yıllarda, genişlemiş spektrumlu beta-laktamaz (GSBL) üreten Enterobacteriaceae türleri, nozokomiyal enfeksiyonların yanı sıra toplum kökenli enfeksiyonlarda da sıklıkla etken olarak karşımıza çıkmaktadır. Yeni geliştirilen ChromID ESBL agar (bioMerieux, Marcy I’Etoile, Fransa), GSBL pozitif Enterobacteriaceae suşlarının hızlı tanımlanmasında kullanılan kromojenik bir besiyeridir. Çalışmamızda, ChromID ESBL agarın, üriner sistem enfeksiyonları (ÜSE)’nda izole edilen GSBL pozitif patojenlerin erken tanısındaki performansının değerlendirilmesi amaçlanmıştır. Çalışmaya, hastanemizin polikliniklerine başvuran (n= 437) ve servislerinde yatan (n= 235) hastalardan alınan toplam 672 idrar örneği dahil edilmiştir. İdrar örneklerinin eş zamanlı olarak %5 koyun kanlı agar, McConkey agar ve ChromID ESBL agara ekimleri yapılmış ve 37°C’de 18-24 saat inkübasyon sonrasında üremeler değerlendirilmiştir. Gram-negatif patojenlerde GSBL varlığını tespit etmek için çift disk sinerji (ÇDS) ve kombine disk difüzyon (KDD) yöntemi (seftazidim ve sefotaksim diskleriyle) uygulanmıştır. Değerlendirmeye alınan 672 idrar örneğinin 199’unda rutin besiyerlerinde (koyun kanlı ve/veya McConkey agar), 57’sinde ise ChromID ESBL agarda üreme saptanmıştır. “Clinical and Laboratory Standards Institute (CLSI)” önerileri doğrultusunda, GSBL varlığının tespiti için KDD yöntemi referans olarak alındığında, ChromID ESBL agarın ÜSE’de GSBL pozitif bakterileri tespit etmedeki duyarlılık, özgüllük, pozitif ve negatif prediktif değerleri sırasıyla %97, %92.9, %89.1 ve %98.1 olarak bulunmuştur. Çalışmamızda, besiyerinin GSBL pozitif bakterilerin yanı sıra vankomisine dirençli enterokok (VRE) türlerinin de üremesine olanak verdiği tespit edilmiş; bunun üzerine, stoklarımızda bulunan vankomisine duyarlı ve dirençli toplam 203 enterokok suşunun bu besiyerine ekimleri yapılmıştır. Vankomisine duyarlı 118 enterokok suşunun hiçbirisinin ChromID ESBL agarda üremediği, 85 VRE suşunun ise 83 (%97.6)’ünün bu besiyerinde ürediği gözlenmiştir. Sonuç olarak, ChromID ESBL agar hem GSBL pozitif Enterobacteriaceae izolatlarını hem de VRE suşlarını farklı renklerde üreterek, ÜSE’de sorun olan bu iki bakteri grubunun erken dönemde tespitine olanak sağlaması nedeniyle avantajlı bir besiyeri olarak değerlendirilmiştir. Özellikle VRE olgularının erken dönemde tespit edilmesinin, nozokomiyal enfeksiyonların önlenmesi için gerekli tedbirlerin alınması açısından yararlı olacağı düşünülmüştür.

🔖

Cite This Article

ALIŞKAN, H. E., ÇOLAKOĞLU, Ş., TURUNÇ, T., DEMİROĞLU, Y. Z. (2012). Evaluation of the chromıd esbl agar for the detection of ESBL-positive Enterobacteriaceae and vancomycin-resistant enterococcus ısolates from urine cultures. Mikrobiyoloji Bülteni, Cilt: 46 - Sayı: 1, 17–25. https://ajindex.com/articles/298754

References (13)

  1. Paterson DL, Bonomo RA. Extended-spectrum beta-lactamases: a clinical update. Clin Microbiol Rev 2005; 18(4): 657-86
  2. Livermore DM, Hawkey PM. CTX-M: changing the face of ESBLs in the UK. J Antimicrob Chemother 2005; 56(3): 451-4
  3. Colodner R, Rock W, Chazan BR, et al. Risk factors for the development of extended-spectrum beta-lactamase- producing bacteria in nonhospitalized patients. Eur J Clin Microbiol Infect Dis 2004; 23(3): 163-7
  4. Hyle EP, Lipworth AD, Zaoutis TE, Nachamkin I, Bilker WB, Lautenbach E. Impact of inadequate initial antimicrobial therapy on mortality in infections due to extended-spectrum beta-lactamase-producing Enterobacteriaceae. Arch Intern Med 2005; 165(12): 1375-80
  5. Livermore DM, Brown DF. Detection of beta-lactamase-mediated resistance. J Antimicrob Chemother 2001; 48(1): 59-64
  6. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. 20 th Informational Supplement. Document M100-S20, 2010. CLSI, Wayne, Pa
  7. Kılıc A, Bedir O, Tunç T, Beşirbellioğlu B, Eyigün CP, Başustaoğlu AC. Bir eğitim hastanesinin çocuk kliniğinde vanA genotip Enterococcus faecium salgını. Mikrobiyol Bul 2009; 43(3): 365-72
  8. Colakoglu S, Aliskan H, Senger SS, Turunc T, Demiroglu YZ, Arslan H. Performance of MRSA ID chromogenic medium for detection of methicillin-resistant Staphylococcus aureus directly from blood cultures and clinical specimens. Diagn Microbiol Infect 2007; 59(3): 319-23
  9. Tazi A, Reglier-Poupet H, Dautezac F, Raymond J, Poyart C. Comparative evaluation of Strepto B ID chromogenic medium and Granada media for the detection of group B streptococcus from vaginal samples of pregnant women. J Microbiol Methods 2008; 73(3): 263-5
  10. Okulicz JF, Rivard RG, Conger NG, Nguyen MX. Hospenthal DR. Primary isolation of Candida species from urine specimens using chromogenic medium. Mycoses 2008; 51(2): 141-6
  11. Ledeboer NA, Tibbetts RJ, Dunne WV. A new chromogenic agar medium, chromID VRE, to screen for vancomycin-resistant Enterococcus faecium and Enterococcus faecalis. Diagn Microbiol Infect Dis 2007; 59(4):477-9
  12. Ciragil P, Gul M, Aral M, Ekerbicer H. Evaluation of a new chromogenic medium for isolation and identification of common urinary tract pathogens. Eur J Clin Microbiol Infect Dis 2006; 25(2): 108-11
  13. Melzer M, Petersen I. Mortality following bacteraemic infection caused by extended spectrum beta-lactamase (ESBL) producing E.coli compared to non-ESBL producing