AUTHOR=Zhang Jingjia , Jia Peiyao , Zhu Ying , Zhang Ge , Xu Yingchun , Yang Qiwen 

TITLE=Performance Evaluation of BD Phoenix NMIC-413 Antimicrobial Susceptibility Testing Panel for Imipenem, Meropenem, and Ertapenem Against Clinical Carbapenem-Resistant and Carbapenem-Susceptible Enterobacterales

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.643194

DOI=10.3389/fmed.2021.643194

ISSN=2296-858X

ABSTRACT=<p><bold>Purpose:</bold> The infection of carbapenem-resistant <italic>Enterobacterales</italic> (CRE) has become a major clinical and healthcare problem worldwide. The screening methods of CRE have been extensively developed but still need improving [e.g., tests with accurate and simple minimum inhibitory (MICs)]. In this study, the performance of the BD Phoenix NMIC-413 AST panel was evaluated against clinical CRE and carbapenem-susceptible <italic>Enterobacterales</italic> (CSE) in China. The panel was first evaluated in the Chinese clinical lab.</p><p><bold>Methods:</bold> Antimicrobial susceptibility testing of 303 clinical <italic>Enterobacterales</italic> isolates were conducted by broth microdilution (BMD), Phoenix NMIC-413 AST panel, and disk diffusion method for imipenem, ertapenem, and meropenem. Considering BMD is a gold standard, essential agreement (EA), categorical agreement (CA), minor error (MIE), major error (ME), and very major error (VME) were determined according to CLSI guidelines. CA and EA &gt; 90%, ME &lt;3%, and VME &lt;1.5% were considered as acceptable criteria. Polymerase chain reaction and sanger sequencing were performed to determine the β-lactamase genotypes of CRE isolates.</p><p><bold>Results:</bold> Three hundred and three isolates included 195 CREs and 108 CSEs were enrolled according to the BMD-MIC values of three carbapenems. Tested CREs showing 100 <italic>bla</italic><sub>KPC−2</sub>-positive organisms, 31 <italic>bla</italic><sub>IMP</sub>-positive organisms, 28 <italic>bla</italic><sub>NDM</sub>-positive organisms, 5 <italic>bla</italic><sub>VIM</sub>-positive organisms, 2 both <italic>bla</italic><sub>IMP</sub> and <italic>bla</italic><sub>VIM</sub>-positive organisms, 2 <italic>bla</italic><sub>OXA−48</sub>-positive organisms, and 27 isolates without carbapenemase genes. For the Phoenix NMIC-413 method, CA and EA rates &gt;93%, MIE rates &lt;5%, ME rates &lt;1.75%, and VME rates were 0%, across the three drugs. For the disk diffusion method, the CA rates for three drugs were all &gt;93%, while the MIE and ME rates were all &lt;5 and &lt;3%, respectively. VME rate was 3.28% for imipenem, exceeded the cut-off value specified by CLSI M52, 0 and 0.56% for ertapenem and meropenem, separately.</p><p><bold>Conclusion:</bold> Based on the genomic data, the detection of CRE and CSE was more reliable using the BD Phoenix NMIC-413 panel compared to the BMD and disk approaches. Therefore, our study supports the use of BD Phoenix NMIC-413 panel as a suitable alternative to BMD for the detection of carbapenem resistant isolates in a clinical setting.</p>