{"title":"评估用于死后生物样本的 O.K.N.V.I. RESIST-5 性能:前瞻性试点研究。","authors":"Iuliana Diac, Lavinia Neculai-Cândea, Mihaela Horumbă, Cătălin Dogăroiu, Mihnea Costescu, Arthur-Atilla Keresztesi","doi":"10.3892/etm.2023.12302","DOIUrl":null,"url":null,"abstract":"In recent years, the emergence of carbapenem-resistant strains has been increasing worldwide, including in Romania. Rapid tests for post-mortem examinations have been researched and currently have several applications. In the present study, we aimed to test the performance of O.K.N.V.I. RESIST-5 tests on impure post-mortem biological samples compared with a standard of pure cultures. When a death occurs during hospitalization and the issue of malpractice arises, the medico-legal practice would benefit from rapid tests applicable to post-mortem samples. Thus, detection and differentiation of the five targeted carbapenemases, namely oxacilinase-48, <i>Klebsiella pneumoniae</i> carbapenemase, New Delhi metallo-β-lactamase, Verona integron-encoded metallo-β-lactamase and imipenemase, could be useful in guiding sampling for third-party microbiological assessment and could also be an asset from an epidemiological standpoint. The present prospective and observational pilot study included medico-legal autopsy cases performed at Mina Minovici National Institute of Legal Medicine (Romania) between June and July 2022. A total of two sets of O.K.N.V.I. RESIST-5 tests were performed: Test I, which was performed on-site from biological samples obtained during autopsy; and Test II, which was performed on pure cultures after sample inoculation and incubation. Total of 39 O.K.N.V.I. RESIST-5 rapid tests were performed on 19 biological samples, at least one sample per case. The O.K.N.V.I. RESIST-5 tests performed on-site showed an overall sensitivity of 92.3% with a 100% specificity. The results obtained through rapid tests using post-mortem impure samples were comparable to the results obtained from sample cultures with good sensitivity and specificity. Through post-mortem screening for carbapenem resistance, it would be possible to narrow down the number of cases that require further bacteriological assessment.","PeriodicalId":12285,"journal":{"name":"Experimental and therapeutic medicine","volume":"73 1","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Assessing O.K.N.V.I. 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Thus, detection and differentiation of the five targeted carbapenemases, namely oxacilinase-48, <i>Klebsiella pneumoniae</i> carbapenemase, New Delhi metallo-β-lactamase, Verona integron-encoded metallo-β-lactamase and imipenemase, could be useful in guiding sampling for third-party microbiological assessment and could also be an asset from an epidemiological standpoint. The present prospective and observational pilot study included medico-legal autopsy cases performed at Mina Minovici National Institute of Legal Medicine (Romania) between June and July 2022. A total of two sets of O.K.N.V.I. RESIST-5 tests were performed: Test I, which was performed on-site from biological samples obtained during autopsy; and Test II, which was performed on pure cultures after sample inoculation and incubation. Total of 39 O.K.N.V.I. RESIST-5 rapid tests were performed on 19 biological samples, at least one sample per case. The O.K.N.V.I. 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引用次数: 0
摘要
近年来,对碳青霉烯类耐药菌株的出现在全球范围内日益增多,罗马尼亚也不例外。用于尸检的快速检测方法已得到研究,目前已有多种应用。在本研究中,我们的目的是测试 O.K.N.V.I. RESIST-5 检验法与纯培养物标准相比在不纯的死后生物样本上的性能。当死亡发生在住院期间,出现渎职问题时,适用于死后样本的快速检测将使医学法律实践受益匪浅。因此,检测和区分五种目标碳青霉烯酶(即氧西林酶-48、肺炎克雷伯氏菌碳青霉烯酶、新德里金属-β-内酰胺酶、维罗纳整合子编码的金属-β-内酰胺酶和亚胺培南酶)可用于指导第三方微生物评估的采样,从流行病学的角度来看也是一种资产。本前瞻性观察试点研究包括 2022 年 6 月至 7 月期间在 Mina Minovici 国立法医学院(罗马尼亚)进行的法医尸检病例。共进行了两组O.K.N.V.I. RESIST-5测试:测试 I 是在解剖过程中获得的生物样本现场进行的;测试 II 是在样本接种和培养后对纯培养物进行的。共对 19 份生物样本进行了 39 次 O.K.N.V.I. RESIST-5 快速检测,每个病例至少检测一份样本。现场进行的 O.K.N.V.I. RESIST-5 测试显示,总体灵敏度为 92.3%,特异性为 100%。使用死后不纯样本进行快速检测所获得的结果与样本培养所获得的结果相当,具有良好的灵敏度和特异性。通过死后碳青霉烯耐药性筛查,可以缩小需要进一步细菌学评估的病例数量。
Assessing O.K.N.V.I. RESIST‑5 performance for post‑mortem biological samples: A prospective pilot study.
In recent years, the emergence of carbapenem-resistant strains has been increasing worldwide, including in Romania. Rapid tests for post-mortem examinations have been researched and currently have several applications. In the present study, we aimed to test the performance of O.K.N.V.I. RESIST-5 tests on impure post-mortem biological samples compared with a standard of pure cultures. When a death occurs during hospitalization and the issue of malpractice arises, the medico-legal practice would benefit from rapid tests applicable to post-mortem samples. Thus, detection and differentiation of the five targeted carbapenemases, namely oxacilinase-48, Klebsiella pneumoniae carbapenemase, New Delhi metallo-β-lactamase, Verona integron-encoded metallo-β-lactamase and imipenemase, could be useful in guiding sampling for third-party microbiological assessment and could also be an asset from an epidemiological standpoint. The present prospective and observational pilot study included medico-legal autopsy cases performed at Mina Minovici National Institute of Legal Medicine (Romania) between June and July 2022. A total of two sets of O.K.N.V.I. RESIST-5 tests were performed: Test I, which was performed on-site from biological samples obtained during autopsy; and Test II, which was performed on pure cultures after sample inoculation and incubation. Total of 39 O.K.N.V.I. RESIST-5 rapid tests were performed on 19 biological samples, at least one sample per case. The O.K.N.V.I. RESIST-5 tests performed on-site showed an overall sensitivity of 92.3% with a 100% specificity. The results obtained through rapid tests using post-mortem impure samples were comparable to the results obtained from sample cultures with good sensitivity and specificity. Through post-mortem screening for carbapenem resistance, it would be possible to narrow down the number of cases that require further bacteriological assessment.