title: Rapid detection of Klebsiella pneumoniae carbapenemase genes in enterobacteriaceae directly from blood culture bottles by real-time PCR.
abstract: Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae are endemic in New York City hospitals and have been associated with serious infections globally. A real-time polymerase chain reaction (RT-PCR) assay was developed to detect carbapenem resistance attributable to KPC from blood culture bottles positive for gram-negative bacilli. Culture confirmation of carbapenemase production included automated imipenem and meropenem susceptibility testing and ertapenem susceptibility testing by disk-diffusion. A total of 323 Enterobacteriaceae isolates were tested, of which 8.7% (n = 28) demonstrated carbapenem-resistance by automated and manual susceptibility testing methods or by RT-PCR. The sensitivity, specificity, and positive and negative predictive values of the RT-PCR assay when compared with the automated method were 92.9%, 99.3%, 92.9%, and 99.3%, respectively, and 96.4%, 99.7%, 96.4%, and 99.7%, respectively, when compared with the ertapenem disk-diffusion method. RT-PCR is a rapid and reliable means of detecting carbapenem resistance due to KPC-plasmids in Enterobacteriaceae directly from blood culture bottles.
authors.affiliation: Department of Pathology and Cell Biology, Columbia University Medical Center-New York Presbyterian Hospital, NY, USA.
authors.forename: Richard O
authors.initials: RO
authors.lastname: Francis
authors.forename: Fann
authors.initials: F
authors.lastname: Wu
authors.forename: Phyllis
authors.initials: P
authors.lastname: Della-Latta
authors.forename: Jun
authors.initials: J
authors.lastname: Shi
authors.forename: Susan
authors.initials: S
authors.lastname: Whittier
mesh_terms: D018929:Cell Culture Techniques / Q000295:instrumentation; D004755:Enterobacteriaceae / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007711:Klebsiella pneumoniae / Q000235:genetics* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D009519:New York City; D011237:Predictive Value of Tests; D060888:Real-Time Polymerase Chain Reaction; D012680:Sensitivity and Specificity