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Evaluation of Disk Potentiation Test (DPT) and Double Disk Synergy Test (DDST) for The Detection of Metallo-β-Lactamases (MBLs) in Clinical Isolates of Bangladesh

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Advances in Infectious Diseases 2023年第4期13卷 609-626页

作者： Sumon Kumar Das Afzal Sheikh nikhat ara Suma Mita Biswas Abhinandan Chowdhury Fatimah Az Zahra Chaman ara Keya Department of Biochemistry & Microbiology North South University Dhaka Bangladesh Department of Microbiology & Immunology Evercare Hospital Dhaka Bangladesh Department of Biochemistry and Molecular Biology Bangabandhu Sheikh Mujibur Rahman Agricultural University Dhaka Bangladesh Institute of Food Safety and Processing (IFSP) Bangabandhu Sheikh Mujibur Rahman Agricultural University Dhaka Bangladesh

Objective: Increasing the emergence of Metallo-β-lactamase (MBL) producing gram-negative bacteria and their dexterous horizontal transmission demands rapid and accurate detection. This study was conducted to determine a suitable method to promptly detect MBL-producing gram-negative bacteria. Methods: A total of 103 gram-negative bacteria were identified from various clinical samples at a tertiary care hospital in Dhaka city. MBL producers were detected by two phenotypic methods, the Disk Potentiation Test (DPT) and the Double Disk Synergy Test (DDST) based on β-lactam chelator combinations where EDTA/SMA has been used as an inhibitor and Imipenem, Ceftazidime as substrates. Results: 103 isolates which were identified as Escherichia coli spp, Klebsiella spp, Pseudomonas spp, Acinetobacter spp, Proteus spp, Providencia spp were found to be multidrug-resistant in antibiogram test. Isolates showed complete resistance (100%) to Imipenem, Meropenem, and Amoxiclav. The highest carbapenem-resistant etiological agents were Acinetobacter spp 40 (38.8%) followed by Pseudomonas spp 27 (26.2%), Klebsiella spp 26 (25.2%), Escherichia coli 8 (7.8%), Proteus spp 1 (1%) and Providencia spp 1 (1%). DPT method detected significantly (p = 0.000009) a higher number of MBL-producers (Imipenem with 0.5 M EDTA n = 61, 59.2% & Ceftazidime with 0.5 M EDTA n = 56, 54.4%) compared to the DDST method (Imipenem -0.5 M EDTA n = 43, 41.7%, Imipenem – SMA n = 38, 36.9% & Ceftazidime -0.5 M EDTA n = 15, 14.6%). Conclusion: Pieces of evidence suggest that DPT is a more sensitive method than DDST and could be recommended for identifying MBL-producing bacteria in Bangladeshi hospitals for the proper management of patients, to reduce time constraints and treatment costs.

关键词： Disk Potentiation Test (DPT) Double Disk Synergy Test (DDST) Metallo-β-Lactamase (MBL) Sodium Mercaptoacetate (SMA) and Ethylenediaminetetraacetic Acid (EDTA)

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