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Abdullah Kilic,Mohammad J. Alam,Naradah L. Tisdel,Dhara N. Shah,Mehmet Yapar,Todd M. Lasco,Kevin W. Garey 대한진단검사의학회 2015 Annals of Laboratory Medicine Vol.35 No.3
Background: The aim of this study was to develop and validate a multiplex real-time PCR assay for simultaneous identification and toxigenic type characterization of Clostridium difficile. Methods: The multiplex real-time PCR assay targeted and simultaneously detected triose phosphate isomerase (tpi) and binary toxin (cdtA) genes, and toxin A (tcdA) and B (tcdB) genes in the first and sec tubes, respectively. The results of multiplex real-time PCR were compared to those of the BD GeneOhm Cdiff assay, targeting the tcdB gene alone. The toxigenic culture was used as the reference, where toxin genes were detected by multiplex real-time PCR. Results: A total of 351 stool samples from consecutive patients were included in the study. Fifty-five stool samples (15.6%) were determined to be positive for the presence of C. difficile by using multiplex real-time PCR. Of these, 48 (87.2%) were toxigenic (46 tcdA and tcdB-positive, two positive for only tcdB) and 11 (22.9%) were cdtA-positive. The sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of the multiplex real-time PCR compared with the toxigenic culture were 95.6%, 98.6%, 91.6%, and 99.3%, respectively. The analytical sensitivity of the multiplex real-time PCR assay was determined to be 103colonyforming unit (CFU)/g spiked stool sample and 0.0625 pg genomic DNA from culture. Analytical specificity determined by using 15 enteric and non-clostridial reference strains was 100%. Conclusions: The multiplex real-time PCR assay accurately detected C. difficile isolates from diarrheal stool samples and characterized its toxin genes in a single PCR run.
Elizabeth Palavecino,Kacy Ramirez,Shermalyn R. Greene,Abdullah Kilic 대한진단검사의학회 2020 Annals of Laboratory Medicine Vol.40 No.3
Dear Editor, Infections due to carbapenem-resistant gram-negative bacteria are a major health problem worldwide. Carbapenem resistance in gram-negative bacteria can result from a diversity of mechanisms: carbapenemase production, porin mutations, increased efflux pump activity, or the presence of enzymes other than carbapenemases. Most carbapenem-resistant isolates produce carbapenemase enzymes, which are found on plasmids that can be easily shared with other gram-negative bacteria [1]. The most common carbapenemase types in gram-negative bacteria are Klebsiella pneumoniae carbapenemase (KPC), New Delhi metallo-β-lactamase (NDM), Verona integron-encoded metallo-β-lactamase (VIM), oxacillinase-48-type carbapenemases (OXA-48), and imipenemase (IMP). A blaKPC-producing K. pneumoniae isolate was first recovered from a patient in North Carolina (NC), USA, in 1996 [2]. Since then, many reports of carbapenem-resistant Enterobacteriaceae (CRE) in hospitalized patients, particularly in the northeastern USA have been published. Carbapenem resistance is also an emerging problem among Pseudomonas aeruginosa isolates in many countries worldwide [3].