[Development and Evaluation of Screening Culture Medium for Detection of Drug-Resistant Gram Negative Rods Containing Stealth Type CPE].

Chinatsu Komatsu, Megumi Oho, Kouji Kusaba, Seiji Kawasaki, Nohara Tsukamoto, Yuya Hirata, Yoshihiro Nagasawa, Yumiko Funashima, Zenzo Nagasawa, Eizaburo Sueoka
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Abstract

There is a report that an infection by medicine resistant bacteria will be the number one cause of death in 2050 according to the recommendation of WHO, and the CPE (carbapenem-producing Enterobacteriaceae) infection is regarded as a problem in particular. When detecting CPE, it is important how to detect stealth type CPE sensitive to carbapenem series medicines. So we used the 2 types of screening culture medium, "KBM" CRE-JU culture medium ‹KOJINBAIO› (CRE-JU culture medium) and the FRPM culture medium, and tried to detect drug-resistant gram-negative bacilli such as CPE, stealth type CPE, ESBL-producing bacteria, and excess AmpC-producing bacteria (AmpC-producing bacteria), etc. in combination of this culture mediums. As a result, CRE-JU culture medium showed a difference in the growth of CPE depending on the amount of inoculated bacteria while β-lactamase non-producing strain and other strains except for high concentration ESBL-producing bacteria and AmpC-producing bacteria were un-growing. Most of the CRE, stealth type CPE, ESBL-producing bacteria and AmpC-producing bacteria grew in the FRPM culture medium while most of the β-lactamase non-producing strains with a MIC value of meropenem (MEPM) of 2 µg/mL or less were un-growing. From these results, it was suggested that when a strain grown on CRE-JU and FRPM culture mediums, it could be distinguished as CPE, and when strains grown on FRPM culture medium which were un-grown on CRE-JU culture medium, it could be distinguished as drug-resistant bacteria such as stealth type CPE, ESBL-producing bacteria, and AmpC-producing bacteria. When strains not grown on CRE-JU and FRPM culture mediums, it could be distinguished as sensitive.

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[含隐型CPE耐药革兰氏阴性棒筛选培养基的研制与评价]。
有报告称,根据世卫组织的建议,耐药细菌感染将成为2050年的头号死亡原因,而CPE(产碳青霉烯类肠杆菌科)感染被认为是一个特别的问题。在检测CPE时,如何检测出对碳青霉烯类药物敏感的隐身型CPE是很重要的。因此,我们选用“KBM”CRE-JU培养基“KOJINBAIO”(CRE-JU培养基)和FRPM培养基2种筛选培养基,尝试结合该培养基检测耐药革兰氏阴性杆菌如CPE、隐身型CPE、产esbl菌、过量产ampc菌(ampc -产菌)等。结果表明,CRE-JU培养基中不同菌量的CPE生长有差异,而不产β-内酰胺酶的菌株和除高浓度产esbl菌和产ampc菌外的其他菌株均未生长。CRE、隐身型CPE、产esbl菌和产ampc菌在FRPM培养基中大部分生长,而美罗培南(MEPM) MIC值为2µg/mL及以下的β-内酰胺酶不产菌大部分不生长。结果表明,菌株在CRE-JU和FRPM培养基上生长时,可区分为CPE;菌株在FRPM培养基上生长时,未在CRE-JU培养基上生长时,可区分为隐形型CPE、产esbl菌和产ampc菌等耐药菌。当菌株不在CRE-JU和FRPM培养基上生长时,可以区分为敏感。
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