title: Phenotypic and molecular characterization of 942 carbapenem-resistant Enterobacteriaceae (CRE) in southern Brazil.
abstract: Carbapenem-resistant Enterobacteriaceae (CRE) is a major international health problem, and its identification in developing countries is based exclusively on phenotypic methods. The aim of this study was to assess the sensitivity and related parameters of the modified Hodge test (MHT). The assessment was performed in a large number of isolates obtained from different hospitals in several cities of a south Brazilian state. Bacterial species were identified using an automated method. The MHT was performed according to the guidelines set by the CLSI. The gene blaKPC was amplified in order to confirmation CRE expression. The sensitivity, specificity, positive, and negative predictive values were calculated. A total of 942 isolates were submitted to the reference laboratory for confirmation; 143 showed a negative MHT (15.18%) result, while 784 were positive (83.23%), and 15 samples displayed an indeterminate MHT (1.59%) result. All samples expressed the KPC-2 enzyme. Sensitivity, specificity, positive, and negative predictive percentiles were 99%, 89%, 98%, and 99% respectively. We conclude that the modified Hodge test is a reliable test for the prediction of KPC-producing bacteria.
authors.affiliation: Division of Infectious Diseases, Universidade Federal do Parana, Curitiba, PR, Brazil; Laboratório Central do Estado LACEN-PR, Brazil.
authors.forename: Lavinia N
authors.initials: LN
authors.lastname: Arend
authors.affiliation: Laboratório Central do Estado LACEN-PR, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Pilonetto
authors.affiliation: Laboratório Central do Estado LACEN-PR, Brazil.
authors.forename: Christian de Alencar
authors.initials: Cde A
authors.lastname: Siebra
authors.affiliation: Division of Infectious Diseases, Universidade Federal do Parana, Curitiba, PR, Brazil. Electronic address: flptuon@gmail.com.
authors.forename: Felipe F
authors.initials: FF
authors.lastname: Tuon
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics; D001938:Brazil / Q000453:epidemiology; D015780:Carbapenems / Q000494:pharmacology*; D004755:Enterobacteriaceae / Q000187:drug effects / Q000235:genetics; D004756:Enterobacteriaceae Infections / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D058889:Molecular Typing / Q000379:methods*; D010641:Phenotype; D011237:Predictive Value of Tests; D018440:beta-Lactam Resistance / Q000235:genetics*; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D001618:beta-Lactamases; C063912:carbapenemase
keywords: Bacteria; Carbapenemase; Enterobacteriaceae; KPC; Modified Hodge test