Polymyxin NP tests (from colonies and directly from blood cultures): accurate and rapid methodologies to detect polymyxin B susceptibility among Enterobacterales

Collar, Gabriela da Silva; Raro, Otávio Hallal Ferreira; Silva, Ravena M.C. da; Vezzaro, P; Mott, Mariana; Cunha, Gabriela Rosa da; Riche, Cezar Vinícius Würdig; Dias, Cícero Armídio Gomes; Caierão, Juliana

doi:10.1016/j.diagmicrobio.2020.115264

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…The Rapid Polymyxin NP Test was tested for polymyxin B and colistin, showing positive results for both, with good sensitivity (ranging from 92 to 100%) and specificity (greater than or equal to 90%). Therefore, the NP test is ideal as a screening methodology, as well as being able to be used in countries that face endemic spread of resistance (carbapenemase producers) [ 11 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ].…”

Section: Phenotypic Methodsmentioning

confidence: 99%

“…isolates showed limitations, with sensitivity and specificity of 25 and 100%, respectively [ 28 ]. The presence of heteroresistant subpopulations may be the cause of the altered sensitivity of the test [ 28 , 31 ].…”

Section: Phenotypic Methodsmentioning

confidence: 99%

“…The Rapid Polymyxin NP Test can also be performed directly from blood cultures, showing good performance, and is easy to implement in laboratories [ 31 , 37 ].…”

Section: Phenotypic Methodsmentioning

confidence: 99%

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Challenges in the Detection of Polymyxin Resistance: From Today to the Future

Rubens,

Arruda,

Almeida

et al. 2024

Microorganisms

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Antimicrobial resistance is known to be one of the greatest global threats to human health, and is one of the main causes of death worldwide. In this scenario, polymyxins are last-resort antibiotics to treat infections caused by multidrug-resistant bacteria. Currently, the reference test to evaluate the susceptibility of isolates to polymyxins is the broth microdilution method; however, this technique has numerous complications and challenges for use in laboratory routines. Several phenotypic methods have been reported as being promising for implementation in routine diagnostics, including the BMD commercial test, rapid polymyxin NP test, polymyxin elution test, culture medium with polymyxins, and the Polymyxin Drop Test, which require materials for use in routines and must be easy to perform. Furthermore, Sensititre®, molecular tests, MALDI-TOF MS, and Raman spectroscopy present reliable results, but the equipment is not found in most microbiology laboratories. In this context, this review discusses the main laboratory methodologies that allow the detection of resistance to polymyxins, elucidating the challenges and perspectives.

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Section: Phenotypic Methodsmentioning

confidence: 99%

Section: Phenotypic Methodsmentioning

confidence: 99%

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Challenges in the Detection of Polymyxin Resistance: From Today to the Future

Rubens,

Arruda,

Almeida

et al. 2024

Microorganisms

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Rapid colorimetric polymyxin B microelution directly from positive blood bottles: because patients with serious infections should not have to wait for results of culture-based methodologies

Collar,

Becker,

Moreira

et al. 2024

Eur J Clin Microbiol Infect Dis

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Detection of polymyxins resistance among Enterobacterales: evaluation of available methods and proposal of a new rapid and feasible methodology

Collar

Moreira

Wink

et al. 2023

Ann Clin Microbiol Antimicrob

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Background Fast and accurate detection of polymyxins resistance is necessary as they remain the last resources to treat infections caused by Carbapenem-resistant Enterobacterales in many regions. We evaluated the rapid colorimetric polymyxin B elution (RCPE) and developed its miniaturized version, RCPE microelution (RCPEm), aiming to detect polymyxins resistance among Enterobacterales. Methods The methodologies consist of exposing the bacterial population in a solution (NP solution) where polymyxin B disks were previously eluted to obtain a concentration of 2 µg/mL for RCPE and 3 µg/mL for RCPEm. Results Two hundred sixty-seven Enterobacterales were evaluated, 90 (33.7%) resistant to polymyxin B by broth microdilution. It was observed 0.6% of major error (ME) by RCPE, with a specificity of 99.4%. The miniaturized version (RCPEm) presented the same ME and specificity values, but slightly higher sensitivity (97.8% vs. 95.6%) with 2.2% of very major error (VME). Conclusions RCPE and RCPEm proved to be useful alternatives to determine polymyxin B susceptibility in clinical microbiology laboratories, presenting low cost, being easy to perform, and demanding short incubation time.

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Polymyxin NP tests (from colonies and directly from blood cultures): accurate and rapid methodologies to detect polymyxin B susceptibility among Enterobacterales

Cited by 3 publications

References 19 publications

Challenges in the Detection of Polymyxin Resistance: From Today to the Future

Challenges in the Detection of Polymyxin Resistance: From Today to the Future

Rapid colorimetric polymyxin B microelution directly from positive blood bottles: because patients with serious infections should not have to wait for results of culture-based methodologies

Detection of polymyxins resistance among Enterobacterales: evaluation of available methods and proposal of a new rapid and feasible methodology

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