Rapid urine test for bacteriuria and beta-lactam resistance in uropathogenic enterobacteria
- Авторлар: Shipitsyna E.V.1, Khusnutdinova T.A.1,2, Goloveshkina E.N.3, Gromova A.V.3, Skachkova T.S.3, Krysanova A.A.1,2, Savicheva A.M.1,2
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Мекемелер:
- D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology
- St. Petersburg State Pediatric Medical University, Ministry of Health of Russia
- Central Research Institute of Epidemiology, Russian Federal Service for Surveillance on Consumer Rights Protection and Human Well-Being
- Шығарылым: № 2 (2023)
- Беттер: 87-97
- Бөлім: Original Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/337990
- DOI: https://doi.org/10.18565/aig.2022.266
- ID: 337990
Дәйексөз келтіру
Ашық рұқсат
Рұқсат берілді
Аннотация
Objective: To develop a rapid urine test for beta-lactam resistance genes in uropathogenic Enterobacteriaceae and compare its diagnostic accuracy with that of the conventional culture method.
Materials and methods: This study analyzed 214 urine samples obtained from women of reproductive age. The susceptibility of the isolated uropathogens to antibiotics was examined using the disk diffusion susceptibility test. Quantitative PCR analysis of urine samples for significant bacteriuria was performed using the AmpliSense IMP-monitor-FL test (Central Research Institute of Epidemiology). Beta-lactam resistance genes were detected using BacResista GLA (DNA Technology), RESISTOM.OXA10, and RESISTOM.DHA (Litech) kits.
Results: According to the culture results, significant bacteriuria was detected in 111 women with Enterobacteriaceae accounting for the vast majority of the cases (94/111; 85%). The sensitivity and specificity of qPCR for the detection of significant bacteriuria (≥104 CFU/ml) were 93–100% and 90–100% for different uropathogens, respectively. Phenotypic and genotypic resistance to beta-lactams was detected in 33% (30/91) and 27% (25/91) of the Enterobacter isolates, respectively. The β-lactamase genes CTX-M, TEM, and DHA were detected in 14% (13/91), 20% (18/91), and 2% (2/91) of the isolates, respectively. All samples that tested negative for β-lactamase genes had a sensitive β-lactam phenotype. Detection of the β-lactam resistance genotype predicted a resistant phenotype with a sensitivity of 87%, specificity of 100%, and positive and negative predictive values of 100 and 94%, respectively.
Conclusion: The rapid urine PCR test for significant bacteriuria and beta-lactam resistance in uropathogenic Enterobacteriaceae was developed.
Толық мәтін
Авторлар туралы
Elena Shipitsyna
D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology
Хат алмасуға жауапты Автор.
Email: shipitsyna@inbox.ru
Dr. Med. Sci., Leading Researcher, Department of Medical Microbiology
Ресей, St. PetersburgTatiana Khusnutdinova
D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology; St. Petersburg State Pediatric Medical University, Ministry of Health of Russia
Email: husnutdinovat@yandex.ru
PhD, Researcher, Department of Medical Microbiology; Assistant, Department of Clinical Laboratory Diagnostics
Ресей, St. Petersburg; St. PetersburgElena Goloveshkina
Central Research Institute of Epidemiology, Russian Federal Service for Surveillance on Consumer Rights Protection and Human Well-Being
Email: elenagoloveshkina@yandex.ru
PhD, Head of the Laboratory for Molecular Diagnostic and Epidemiology of Reproductive Tract Infections
Ресей, MoscowAnastasia Gromova
Central Research Institute of Epidemiology, Russian Federal Service for Surveillance on Consumer Rights Protection and Human Well-Being
Email: gromova@cmd.su
PhD, Researcher, Laboratory for Molecular Diagnostic and Epidemiology of Reproductive Tract Infections
Ресей, MoscowTatyana Skachkova
Central Research Institute of Epidemiology, Russian Federal Service for Surveillance on Consumer Rights Protection and Human Well-Being
Email: skachkova@inbox.ru
Researcher, Laboratory for Molecular Diagnostic and Epidemiology of Reproductive Tract Infections
Ресей, MoscowAnna Krysanova
D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology; St. Petersburg State Pediatric Medical University, Ministry of Health of Russia
Email: krusanova.anna@mail.ru
PhD, Researcher, Department of Medical Microbiology; Teaching Assistant, Department of Clinical Laboratory Diagnostics
Ресей, St. Petersburg; St. PetersburgAlevtina Savicheva
D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology; St. Petersburg State Pediatric Medical University, Ministry of Health of Russia
Email: savitcheva@mail.ru
Dr. Med. Sci., Professor, Head of the Department of Medical Microbiology; Head of the Department of Clinical Laboratory Diagnostics
Ресей, St. Petersburg; St. PetersburgӘдебиет тізімі
- Ansaldi Y., Martinez de Tejada Weber B. Urinary tract infections in pregnancy. Clin. Microbiol. Infect. 2022 Aug 27; S1198-743X. https://dx.doi.org/10.1016/ J.CMI.2022.08.015.
- De Angelis G., Del Giacomo P., Posteraro B., Sanguinetti M., Tumbarello M. Molecular mechanisms, epidemiology, and clinical importance of β-lactam resistance in enterobacteriaceae. Int.. J Mol. Sci. 2020; 21(14): 5090. https://dx.doi.org/10.3390/IJMS21145090.
- Bush K. Past and present perspectives on β-lactamases. Antimicrob. Agents Chemother. 2018; 62(10): e01076-18. https://dx.doi.org/10.1128/ AAC.01076-18.
- Bonkat G., Bartoletti R., Bruyère F., Cai T., Geerlings S.E., Köves B. et al. EAU guidelines on urological infections. 2022. Available at: https://d56bochluxqnz.cloudfront.net/documents/full-guideline/ EAU-Guidelines-on-Urological-Infections-2022.pdf
- Ministry of Health of the Russian Federation. Clinical guidelines. Urinary tract infections in pregnancy. 2021. (in Russian). Available at: https://roag-portal.ru/recommendations_obstetrics
- Kaye K.S., Rice L.B., Dane A.L., Stus V., Sagan O., Fedosiuk E. et al. Fosfomycin for injection (ZTI-01) versus piperacillin-tazobactam for the treatment of complicated urinary tract infection including acute pyelonephritis: ZEUS, a phase 2/3 randomized trial. Clin. Infect. Dis. 2019; 69(12): 2045-56. https://dx.doi.org/10.1093/CID/CIZ181.
- Sojo-Dorado J., López-Hernández I., Rosso-Fernandez C., Morales I.M., Palacios-Baena Z.R., Hernández-Torres A. et al. Effectiveness of fosfomycin for the treatment of multidrug-resistant escherichia coli bacteremic urinary tract infections: a randomized clinical trial. JAMA Netw Open. 2022; 5(1): e2137277. https://dx.doi.org/10.1001/JAMANETWORKOPEN.2021.37277.
- Fleece M.E., Pholwat S., Mathers A.J., Houpt E.R. Molecular diagnosis of antimicrobial resistance in Escherichia coli. Expert Rev. Mol. Diagn. 2018; 18(3): 207-17. https://dx.doi.org/10.1080/14737159.2018.1439381.
- De Angelis G., Grossi A., Menchinelli G., Boccia S., Sanguinetti M., Posteraro B. Rapid molecular tests for detection of antimicrobial resistance determinants in Gram-negative organisms from positive blood cultures: a systematic review and meta-analysis. Clin. Microbiol. Infect. 2020; 26(3): 271-80. https://dx.doi.org/10.1016/J.CMI.2019.11.009.
- Wojno K.J., Baunoch D., Luke N., Opel M., Korman H., Kelly C. et al. Multiplex PCR based urinary tract infection (UTI) analysis compared to traditional urine culture in identifying significant pathogens in symptomatic patients. Urology. 2020; 136: 119-26. https://dx.doi.org/10.1016/j.urology.2019.10.018.
- Sun Z., Liu W., Zhang J., Wang S., Yang F., Fang Y. et al. The direct semi-quantitative detection of 18 pathogens and simultaneous screening for nine resistance genes in clinical urine samples by a high-throughput multiplex genetic detection system. Front. Cell. Infect. Microbiol. 2021; 11: 660461. https://dx.doi.org/10.3389/fcimb.2021.660461.
- Van Der Zee A., Roorda L., Bosman G., Ossewaarde J.M. Molecular diagnosis of urinary tract infections by semi-quantitative detection of uropathogens in a routine clinical hospital setting. PLoS One. 2016; 11(3): e0150755. https://dx.doi.org/10.1371/journal.pone.0150755.
- Martinez-Martinez L., Cantón Spain R., Stefani S., Skov R., Glupczynski Y., Nordmann P. et al. EUCAST guidelines for detection of resistance mechanisms and specific resistances of clinical and/or epidemiological importance. 2017. Available at: https://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Resistance_mechanisms/EUCAST_detection_of_resistance_mechanisms_170711.pdf
- Bujang M.A., Adnan T.H. Requirements for minimum sample size for sensitivity and specificity analysis. J. Clin. Diagn. Res. 2016; 10(10): YE01. https://dx.doi.org/10.7860/JCDR/2016/18129.8744.
- Tofteland S., Haldorsen B., Dahl K.H., Simonsen G.S., Steinbakk M., Walsh T.R. et al. Effects of phenotype and genotype on methods for detection of extended-spectrum-β-lactamase-producing clinical isolates of Escherichia coli and Klebsiella pneumoniae in Norway. J. Clin. Microbiol. 2007; 45(1): 199-205. https://dx.doi.org/10.1128/JCM.01319-06.
- Tuite N., Reddington K., Barry T., Zumla A., Enne V. Rapid nucleic acid diagnostics for the detection of antimicrobial resistance in Gram-negative bacteria: Is it time for a paradigm shift? J. Antimicrob. Chemother. 2014; 69(7): 1729-33. https://dx.doi.org/10.1093/jac/dku083.
- Ny S., Edquist P., Dumpis U., Gröndahl-Yli-Hannuksela K., Hermes J., Kling A.M. et al. Antimicrobial resistance of Escherichia coli isolates from outpatient urinary tract infections in women in six European countries including Russia. J. Glob. Antimicrob. Resist. 2019; 17: 25-34. https://dx.doi.org/10.1016/ j.jgar.2018.11.004.
- Palagin I.S., Sukhorukova M.V., Dekhnich A.V., Edelstein M.V., Perepanova T.S., Kozlov R.S. et al. Antimicrobial resistance of pathogens causing community-acquired urinary tract infections in Russia: results of multicenter study “DARMIS-2018”. CMAC. 2019; 21(2): 134-46. (in Russian). https://dx.doi.org/10.36488/cmac.2019.2.134-146.
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