Evaluation of Poly NP test and MPNP test for rapid detection of the polymyxin resistance Klebsiella pneumoniae

doi:10.12092/j.issn.1009-2501.2019.06.008

Abstract

Abstract:

AIM: To evaluate the screening capacity of rapid polymyxin NP test (Poly NP test) for the detection of polymyxin B resistance Klebsiella pneumoniae (PolR-KP) and the modified rapid polymyxin Nordmann/Poirel test (MPNP) for the MCR-producing in K.pneumoniae. METHODS: A total of 48 isolates were selected, in which, 14 strains were polymyxin sensitive Klebsiella pneumoniae (PolS-KP), 26 strains were PolR-KP, 3 strains were polymyxin intrinsic resistance and 5 strains of nonfermenters. The rapid polymyxin NP test was used to detect the polymyxin resistance phenotype and the results were compared with the MICs determined by the BMD method, which was taken as the gold standard. The PCR and sequencing were used to screen the polymyxin resistance determinants caused by chromosomal mutations-the two-component phoP/phoQ, pmrA/pmrB and the mgrB gene; and also screen the presence of mcr-1, mcr-2, mcr-3, mcr-4, mcr-5, mcr-6, mcr-7 and mcr-8. The MCR-producing Klebsiella pneumoniae isolates were detected by MPNP test. RESULTS:All the polymyxin intrinsic resistance strains were positive in Poly NP test, of the 26 isolates PolR-KP, 24 PolR-KP strains were positive in Poly NP test and only 2 strains showed negative result. The sensitivity and specificity of Poly NP test were 93.1% and 100%. Of the 22 isolates which polymyxin resistance was associated with chromosome-encoded mechanisms, 12 isolates had mutations in the pmrA/pmrB two-component system, 4 isolates in the phoP/phoQ two-component system and 6 isolates had different alterations in mgrB gene. 4 strains of MCR-producing K. pneumoniae were detected in PolR-KP and the MPNP test showed lack of inhibitory effect of EDTA on the mcr-positive K. pneumoniae strains. CONCLUSION: The Poly NP test is an easy-to-perform, rapid, sensitive, and specific test and making it a potential useful clinical technique for the detection of PolR-KP, while the MCR-positive K.pneumoniae strains are not identified by the MPNP test. Further methods suitable for rapid detection of the MCR-producing in K.pneumoniae are uegently needed.

Key words: polymyxin resistant, colistin resistant, Klebsiella pneumoniae, rapid detection, phenotypic detection

CLC Number:

R965.2
R978

LIU Yanling, ZENG Lingbing, HU Niya, CHEN Kaisen, HU Xuefei, HU Longhua. Evaluation of Poly NP test and MPNP test for rapid detection of the polymyxin resistance Klebsiella pneumoniae[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2019, 24(6): 650-657.

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