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العنوان
CHROMagar KPC for Detection of Carbapenem Resistant Enterobacteriaceae from Rectal Swabs /
المؤلف
Mohamed, Marwa Ramadan.
هيئة الاعداد
باحث / مروه رمضان محمد
مشرف / هالة بدر الدين علي عثمان
مشرف / داليا حسني عبد الحميد
مشرف / ولاء وسام علي محروس
تاريخ النشر
2015.
عدد الصفحات
168 p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
أمراض الدم
تاريخ الإجازة
1/1/2015
مكان الإجازة
جامعة عين شمس - كلية الطب - الباثولوجيا الإكلينيكية والكيميائية
الفهرس
Only 14 pages are availabe for public view

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from 168

Abstract

Carbapenemase-producing Enterobacteria (CPE) cause serious infections in debilitated and immunocompromised patients, in association with prolonged hospital stays and increased mortality rates, ranging from 24% to as high as 70%. Given the critical condition of these patients, treatment should be timely, aggressive, and rapidly efficacious. However, therapeutic options are obviously limited. So focus has shifted towards surveillance for early detection of carbapenemase in microbiology laboratories.
At this time, KPCs are the most prevalent and clinically relevant β-lactamases of the Ambler Class-A carbapenemase . This genotype of resistance has been extensively reported in Enterobacteriaceae and in some non-fermentative Gram-negative bacilli as Pseudomonas spp. and Acinetobacter spp.
Over the last few years, several chromogenic media have been developed and commercialized, allowing more specific and direct differentiation of microorganisms on the primary plates. They not only minimize the need for further identification tests but also reduce the time required to report the results to the clinician to facilitate early initiation of antibiotic therapy.
The aim of this work is to assess chrOMagar KPC for detection of KPC producing carbapenam resistant Enterobacteriaceae from rectal swabs of ICU patients.
During this study rectal swabs from 138 patients were collected from Geriatric, Internal medicine, neurological and surgical ICUs two swabs from each patient and were transferred to the Microbiology Laboratory to be cultured on chrOMagar KPC media, then Modified Hodge test was performed to the isolates to confirm carbapenemase production phenotypically. Only 100 swabs were subjected to direct detection of blaKPC gene by real time PCR.
One hundred 100/138 (72.5%) patients were carrier of CRE assessed by chrOMagar KPC of whom 93/100(93%) were CRE by MHT.
Only one hundred swabs (100/138) were subjected to PCR. Seventy four (74/100) rectal swabs were positive for bla KPC by PCR, sixty nine (69/100) rectal swabs were CRE by chrOMagar KPC and (64/100) rectal swabs were CPE by MHT.
CHROMagar KPC showed a sensitivity, specificity, PPV and NPV of 83.8%, 73.1%, 89.8% and 61.3% respectively compared to PCR with a moderate significant agreement between them.
While MHT showed a sensitivity, specificity, PPV and NPV of 77.0%, 73.1%, 89.1% and 52.8% respectively compared to PCR with moderate significant agreement between them.
Both chrOMagar KPC and MHT were positive in 92.7%. There was no significant difference between them regarding sensitivity and specificity compared to PCR as a reference method.