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Improving the Efficiency of the Modified Hodge Test in KPC-Producing Klebsiella pneumoniae Isolates by Incorporating an EDTA Disk

Current Microbiology volume 69, pages 47–52 (2014)Cite this article

Abstract

Carbapenemase-producing Klebsiella pneumoniae have emerged as an important pathogens in nosocomial infections with high mortality rate. Although the modified Hodge test (MHT) is recommended for phenotypic detection of carbapenemase-producing Enterobacteriaceae, high false-positive rates were reported for MHT results. The MHT has acceptable sensitivity (98.0 %), but it lacks specificity (73.6 %). In this study, we incorporated an EDTA disk test into the MHT (MHT-EDTA) to improve the efficiency in phenotypic detection of K. pneumoniae carbapenemase (KPC) of K. pneumoniae isolates. EDTA was used to lyse the cells of 123 carbapenem non-susceptible K. pneumoniae isolates to release the β-lactamases. The MHT-EDTA achieved 100 % sensitivity and specificity for KPC detection among K. pneumoniae isolates as compared to growth patterns of the indicator organism E. coli (ATCC 25922). This method could be carried out as part of routine work to provide useful information for the clinical management of K. pneumoniae infection.

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Acknowledgments

This study was supported by grants from the Research Grant for Health Science and Technology of Pudong Health Bureau of Shanghai (Grant No.PW2011A-22 and No. PWRq2013-12).The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Affiliations

  1. Department of Clinical Laboratory, Pudong Hospital, Fudan University, Shanghai, China

    Yuzhong Yan, Huanzhang Yang, Huiqin Fan, Yanchun Lu & Yi Shi

  2. Department of Psychology, Nanhui Mental Health Center, Shanghai, China

    Lihong Pan

  3. Department of Clinical Laboratory, The Ninth People’s Hospital, Jiaotong University, Shanghai, China

    Kangde Sun

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  1. Yuzhong Yan
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  2. Huanzhang Yang
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  3. Lihong Pan
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  4. Kangde Sun
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  5. Huiqin Fan
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  6. Yanchun Lu
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  7. Yi Shi
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Correspondence to Yi Shi.

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Yuzhong Yan and Huanzhang Yang contributed equally to this work.

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Yan, Y., Yang, H., Pan, L. et al. Improving the Efficiency of the Modified Hodge Test in KPC-Producing Klebsiella pneumoniae Isolates by Incorporating an EDTA Disk. Curr Microbiol 69, 47–52 (2014). https://doi.org/10.1007/s00284-014-0552-5

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  • DOI: https://doi.org/10.1007/s00284-014-0552-5

Keywords

  • Carbapenem
  • Minimal Inhibitory Concentration
  • AmpC
  • ESBL Producer
  • Carbapenem Resistance