Cepas produtoras de carbapenemase : análise da eficácia de novo teste rápido para sua identificação

Abstract

INTRODUCTION: according to the World Health Organization (WHO), healthcare-associated infections with resistant organisms are one of the leading causes of death among infectious diseases. The number of infections of Klebsiella pneumoniae carbapenemase (KPC) in Brazil, it is increasing, in addition to the clinical impact, can cause a huge economic burden on developing countries. The gold standard for detection of carbapenemase is the polymerase chain reaction (PCR), however these molecular techniques are generally expensive, laborious, time consuming and are not easily available in clinical laboratories, in this way, alternative approaches that can bring good results can be important allies for a clinical microbiology laboratory that has not this technology. OBJECTIVE: Analyze the effectiveness of the Carbapenembac® rapid test for identification of carbapenemase producing strains isolated from clinical specimens in the microbiological laboratory routine. METHODS: were included in this study a total of 50 samples non-duplicated, with clinical isolates of Klebsiella pneumoniae resistant to carbapenêmicos, which were collected in the period from November to June 2015 to 2016 the laboratory Santa Rosa in Santa Rosa Hospital, Cuiabá-MT. Antimicrobial susceptibility was performed automatically through the system 100 PhoenixTM of Becton Dickinson using interpretation the CLSI. The detection by the carbapenembac rapid test was performed according to the manufacturer's instructions. Detection of the gene blaKPC by molecular methods (qPCR) was conducted Universidade Federal de Ciências da Saúde de Porto Alegre-UFCSPA in order to compare the test with the gold standard. RESULTS AND DISCUSSIONS: the KPC detection for quick test was positive for 47/50. The results of the qPCR were positive in all samples. The positive predictive value was 94%, the negative predictive value of 62.5%, 94% sensitivity and 100% specificity. CONCLUSION: 3/50 tested isolates showed negative results for carbapenemase production in the rapid test, being positive in the gold standard. Few negative samples for KPC were tested, so the specificity may have been overestimated (100%). Comparing the results obtained by the rapid test and the gold standard, the tests showed high sensitivity (94%) being a good screening test in laboratory routine.