Hüseyin Haydar KUTLU, Alper TEKELİ, Ebru US

Karbapenemaz Üreticisi Enterobacteriaceae İzolatlarının Saptanmasında Modifiye Hodge Testi ile İnhibitör Tabanlı Testlerin Karşılaştırılması

Amaç: Karbapenemaz üreten Enterobacteriaceae izolatlarının hızlı ve doğru tanısı, yayılımı önleme ve tedavi stratejilerini belirlemede önemlidir. Modifiye Hodge testi (MHT) karbapenemaz aktivitesini fenotipik olarak saptamak için kullanılan kolay ve ucuz bir yöntemdir. Aynı amaçla kullanılan diğer yöntem inhibitör tabanlı testlerdir (İTT). Bu çalışmanın amacı bu iki fenotipik yöntemin Enterobacteriaceae izolatlarında karbapenemazları saptama performanslarının karşılaştırılmasıdır. Gereç ve Yöntem: 2010-2014 yılları arasında Ankara Üniversitesi Tıp Fakültesi İbni Sina Hastanesi Merkez Mikrobiyoloji Laboratuvarı'nda farklı hastalara ait çeşitli klinik örneklerden izole edilen, Kirby-Bauer disk difüzyon yöntemiyle ertapeneme orta duyarlılık ya da direnç gösteren Enterobacteriaceae ailesindeki 112 adet tekrar etmeyen klinik izolat çalışmaya dahil edilmiştir. Bulgular: MHT, 1:10 sulandırım [0,05 McFarland (McF)] kullanılarak yapıldığında karbapenemaz kodlayan gen (KKG)'leri pozitif 94 izolatın 7'sinde yalancı negatif; KKG negatif 18 izolatın 16'sında yalancı pozitif sonuç alınmış ve MHT'nin karbapenemazları saptamadaki duyarlılığı % 92,6 bulunmuştur. Sulandırım adımı uygulanmadığında (0,5 McF) yalancı negatif izolat sayısı 3'e düşmüş ve testin duyarlılığı % 96,8'e yükselmiştir (p

Comparison of the Modified Hodge Test and Inhibitor-Based Tests for Detection of Carbapenemase-Producing Enterobacteriaceae Isolates

Aim: Rapid and accurate detection of carbapenemase producing Enterobacteriaceae isolates plays an important role in preventing the spread and defining treatment strategies.The modified Hodge test (MHT) is an easy and inexpensive tool that can be used to detect carbapenemase activity. Another method used for the same purpose are inhibitor-based tests (IBTs). The aim of this study is to compare the performances of these two phenotypic methods in the detection of carbapenemases in Enterobacteriaceae isolates. Materials and Methods: A total of 112 non-repeat Enterobacteriaceae strains isolated from various clinical samples at Ibni Sina Hospital Central Microbiology Laboratory between 2010-2014 that showed decreased sensitivity and resistance to ertapenem by Kirby-Bauer disk diffusion method were included in the study. Results: When 1:10 dilution [0,05 McFarland (McF)] was performed, out of 94 isolates positive for carbapenemase-encoding genes (CEGs), false negativity was detected in seven isolates, whereas out of 18 isolates negative for CEGs, false positivity was detected in 16 isolates; so the sensitivity of MHT for carbapenemase detection was found to be 92,6%. Without dilution (0.5 McF) the number of false negative isolates decreased to three and the sensitivity of MHT increased to 96,8%, (p

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