Difficulty in detecting low levels of polymyxin resistance in clinical Klebsiella pneumoniae isolates: evaluation of Rapid Polymyxin NP test, Colispot Test and SuperPolymyxin medium

dc.creatorConceição Neto, O. C.
dc.creatorCosta, B. S. da
dc.creatorPontes, L. S.
dc.creatorSantos, I. C. O.
dc.creatorSilveira, M. C.
dc.creatorMoura, J. R. Cordeiro
dc.creatorPereira, N. F.
dc.creatorTeixeira, C. B. Tavares
dc.creatorPicão, R. C.
dc.creatorSouza, C. M. Rocha de
dc.creatorCarvalho-Assef, A. P. D´A.
dc.date2020-08-06T18:52:36Z
dc.date2020-08-06T18:52:36Z
dc.date2020
dc.date.accessioned2023-09-26T23:17:33Z
dc.date.available2023-09-26T23:17:33Z
dc.identifierCONCEIÇÃO NETO, O. C. et al. Difficulty in detecting low levels of polymyxin resistance in clinical Klebsiella pneumoniae isolates: evaluation of Rapid Polymyxin NP test, Colispot Test and SuperPolymyxin medium. New Microbe and New Infect., v. 36, 100722, 7p, 2020.
dc.identifier2052-2975
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/42578
dc.identifier10.1016/j.nmni.2020.100722
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8888958
dc.descriptionAcesso aberto em 06/08/2020 - https://www.sciencedirect.com/science/article/pii/S2052297520300743
dc.descriptionPolymyxins are important therapeutic options for treating infections, mainly those caused by carbapenem-resistant Klebsiella pneumoniae. Specific chemical characteristics of polymyxins make it difficult to perform antimicrobial susceptibility testing, especially within the clinical laboratory. Here we aimed to evaluate the performance of three phenotypic methods: Rapid NP Polymyxin Test, ColiSpot test and the SuperPolymyxin medium. To accomplish this, 170 non-duplicate clinical K. pneumoniae isolates were analysed (123 colistin-resistant and 47 susceptible). The sensitivity and specificity obtained for Rapid Polymyxin NP Test, Colispot and SuperPolymyxin medium were, respectively, 90% and 94%, 74% and 100%, and 82% and 85%. Very major errors occurred more frequently in low-level colistin-resistant isolates (MICs 4 and 8 μg/mL). Rapid Polymyxin NP proved to be a method capable of identifying colistin-resistant strains in acceptable categorical agreement. However, major errors and very major errors of this method were considered unacceptable for colistinresistance screening. Although the Colispot test is promising and easy to perform and interpret, the results did not reproduce well in the isolates tested. The colistin-containing selective medium (SuperPolymyxin) showed limitations, including quantification of mucoid colonies and poor stability. Nevertheless, Colispot and SuperPolymyxin medium methods did not present acceptable sensitivity, specificity and categorical agreement. It is essential to use analytical tools that faithfully reproduce bacterial resistance in vitro, especially in last-line drugs, such as polymyxins, when misinterpretation of a test can result in therapeutic ineffectiveness.
dc.formatapplication/pdf
dc.languageeng
dc.publisherElsevier
dc.rightsopen access
dc.subjectResistência a antibióticos
dc.subjectIsolados clínicos
dc.subjectKlebsiella pneumoniae
dc.subjectDetecção fenotípica
dc.subjectResistência à polimíxina
dc.subjectAntibiotic resistance
dc.subjectClinical isolates
dc.subjectKlebsiella pneumoniae
dc.subjectPhenotypic detection
dc.subjectPolymyxin resistance
dc.titleDifficulty in detecting low levels of polymyxin resistance in clinical Klebsiella pneumoniae isolates: evaluation of Rapid Polymyxin NP test, Colispot Test and SuperPolymyxin medium
dc.typeArticle


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