Ertapenem Supplemented Selective Media as a New Strategy to Distinguish β-Lactam-Resistant Enterobacterales: Application to Clinical and Wastewater Samples
The increase in carbapenem-resistant Enterobacterales (CRE) is mostly driven by the spread of carbapenemase-producing (CP) strains. In New Caledonia, the majority of carbapenemases found are IMP-type carbapenemases that are difficult to detect on routine selective media. In this study, a culture-bas...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-02-01
|
| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/12/2/392 |
| _version_ | 1797622806009085952 |
|---|---|
| author | Alexandre Bourles Malia Kainiu Damaris Ukeiwe Nina Brunet Camille Despaux Antoine Biron Ann-Claire Gourinat Cyrille Goarant Julien Colot |
| author_facet | Alexandre Bourles Malia Kainiu Damaris Ukeiwe Nina Brunet Camille Despaux Antoine Biron Ann-Claire Gourinat Cyrille Goarant Julien Colot |
| author_sort | Alexandre Bourles |
| collection | DOAJ |
| description | The increase in carbapenem-resistant Enterobacterales (CRE) is mostly driven by the spread of carbapenemase-producing (CP) strains. In New Caledonia, the majority of carbapenemases found are IMP-type carbapenemases that are difficult to detect on routine selective media. In this study, a culture-based method with ertapenem selection is proposed to distinguish non-CRE, non-CP-CRE, and CP-CRE from samples with very high bacterial loads. Firstly, assays were carried out with phenotypically well-characterized β-lactam-resistant Enterobacterales isolates. Then, this approach was applied to clinical and environmental samples. Presumptive CP-CRE isolates were finally identified, and the presence of a carbapenemase was assessed. In a collection of 27 phenotypically well-characterized β-lactam-resistant Enterobacterales, an ertapenem concentration of 0.5 µg·mL<sup>−1</sup> allowed distinguishing CRE from non-CRE. A concentration of 4 µg·mL<sup>−1</sup> allowed distinguishing CP-CRE from non-CP-CRE after nine hours of incubation. These methods allowed isolating 18 CP-CRE from hospital effluents, including the first detection of a KPC in New Caledonia. All these elements show that this cost-effective strategy to distinguish β-lactam-resistant Enterobacterales provides fast and reliable results. This could be applied in the Pacific islands or other resource-limited settings, where limited data are available. |
| first_indexed | 2024-03-11T09:15:29Z |
| format | Article |
| id | doaj.art-e9211e21aa8a4599b686e4a89a4c5705 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-11T09:15:29Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-e9211e21aa8a4599b686e4a89a4c57052023-11-16T18:44:25ZengMDPI AGAntibiotics2079-63822023-02-0112239210.3390/antibiotics12020392Ertapenem Supplemented Selective Media as a New Strategy to Distinguish β-Lactam-Resistant Enterobacterales: Application to Clinical and Wastewater SamplesAlexandre Bourles0Malia Kainiu1Damaris Ukeiwe2Nina Brunet3Camille Despaux4Antoine Biron5Ann-Claire Gourinat6Cyrille Goarant7Julien Colot8Institut Pasteur de Nouvelle-Calédonie, Pôle de Bactériologie, Groupe de Bactériologie Médicale et Environnementale, CEDEX BP 61, Noumea 98845, New CaledoniaInstitut Pasteur de Nouvelle-Calédonie, Pôle de Bactériologie, Groupe de Bactériologie Médicale et Environnementale, CEDEX BP 61, Noumea 98845, New CaledoniaInstitut Pasteur de Nouvelle-Calédonie, Pôle de Bactériologie, Groupe de Bactériologie Médicale et Environnementale, CEDEX BP 61, Noumea 98845, New CaledoniaCRESICA Department, Université de la Nouvelle-Calédonie, CEDEX BP R4, Noumea 98851, New CaledoniaInstitut Pasteur de Nouvelle-Calédonie, Pôle de Bactériologie, Groupe de Bactériologie Médicale et Environnementale, CEDEX BP 61, Noumea 98845, New CaledoniaCentre Hospitalier Territorial Gaston-Bourret, Laboratoire de Biologie Médicale, CEDEX BP J5, Noumea 98849, New CaledoniaCentre Hospitalier Territorial Gaston-Bourret, Laboratoire de Biologie Médicale, CEDEX BP J5, Noumea 98849, New CaledoniaInstitut Pasteur de Nouvelle-Calédonie, Pôle de Bactériologie, Groupe de Bactériologie Médicale et Environnementale, CEDEX BP 61, Noumea 98845, New CaledoniaInstitut Pasteur de Nouvelle-Calédonie, Pôle de Bactériologie, Groupe de Bactériologie Médicale et Environnementale, CEDEX BP 61, Noumea 98845, New CaledoniaThe increase in carbapenem-resistant Enterobacterales (CRE) is mostly driven by the spread of carbapenemase-producing (CP) strains. In New Caledonia, the majority of carbapenemases found are IMP-type carbapenemases that are difficult to detect on routine selective media. In this study, a culture-based method with ertapenem selection is proposed to distinguish non-CRE, non-CP-CRE, and CP-CRE from samples with very high bacterial loads. Firstly, assays were carried out with phenotypically well-characterized β-lactam-resistant Enterobacterales isolates. Then, this approach was applied to clinical and environmental samples. Presumptive CP-CRE isolates were finally identified, and the presence of a carbapenemase was assessed. In a collection of 27 phenotypically well-characterized β-lactam-resistant Enterobacterales, an ertapenem concentration of 0.5 µg·mL<sup>−1</sup> allowed distinguishing CRE from non-CRE. A concentration of 4 µg·mL<sup>−1</sup> allowed distinguishing CP-CRE from non-CP-CRE after nine hours of incubation. These methods allowed isolating 18 CP-CRE from hospital effluents, including the first detection of a KPC in New Caledonia. All these elements show that this cost-effective strategy to distinguish β-lactam-resistant Enterobacterales provides fast and reliable results. This could be applied in the Pacific islands or other resource-limited settings, where limited data are available.https://www.mdpi.com/2079-6382/12/2/392antimicrobial resistancecarbapenemase-producing-carbapenem-resistant-enterobacteralesertapenemwastewaterculture-based approachNew Caledonia |
| spellingShingle | Alexandre Bourles Malia Kainiu Damaris Ukeiwe Nina Brunet Camille Despaux Antoine Biron Ann-Claire Gourinat Cyrille Goarant Julien Colot Ertapenem Supplemented Selective Media as a New Strategy to Distinguish β-Lactam-Resistant Enterobacterales: Application to Clinical and Wastewater Samples Antibiotics antimicrobial resistance carbapenemase-producing-carbapenem-resistant-enterobacterales ertapenem wastewater culture-based approach New Caledonia |
| title | Ertapenem Supplemented Selective Media as a New Strategy to Distinguish β-Lactam-Resistant Enterobacterales: Application to Clinical and Wastewater Samples |
| title_full | Ertapenem Supplemented Selective Media as a New Strategy to Distinguish β-Lactam-Resistant Enterobacterales: Application to Clinical and Wastewater Samples |
| title_fullStr | Ertapenem Supplemented Selective Media as a New Strategy to Distinguish β-Lactam-Resistant Enterobacterales: Application to Clinical and Wastewater Samples |
| title_full_unstemmed | Ertapenem Supplemented Selective Media as a New Strategy to Distinguish β-Lactam-Resistant Enterobacterales: Application to Clinical and Wastewater Samples |
| title_short | Ertapenem Supplemented Selective Media as a New Strategy to Distinguish β-Lactam-Resistant Enterobacterales: Application to Clinical and Wastewater Samples |
| title_sort | ertapenem supplemented selective media as a new strategy to distinguish β lactam resistant enterobacterales application to clinical and wastewater samples |
| topic | antimicrobial resistance carbapenemase-producing-carbapenem-resistant-enterobacterales ertapenem wastewater culture-based approach New Caledonia |
| url | https://www.mdpi.com/2079-6382/12/2/392 |
| work_keys_str_mv | AT alexandrebourles ertapenemsupplementedselectivemediaasanewstrategytodistinguishblactamresistantenterobacteralesapplicationtoclinicalandwastewatersamples AT maliakainiu ertapenemsupplementedselectivemediaasanewstrategytodistinguishblactamresistantenterobacteralesapplicationtoclinicalandwastewatersamples AT damarisukeiwe ertapenemsupplementedselectivemediaasanewstrategytodistinguishblactamresistantenterobacteralesapplicationtoclinicalandwastewatersamples AT ninabrunet ertapenemsupplementedselectivemediaasanewstrategytodistinguishblactamresistantenterobacteralesapplicationtoclinicalandwastewatersamples AT camilledespaux ertapenemsupplementedselectivemediaasanewstrategytodistinguishblactamresistantenterobacteralesapplicationtoclinicalandwastewatersamples AT antoinebiron ertapenemsupplementedselectivemediaasanewstrategytodistinguishblactamresistantenterobacteralesapplicationtoclinicalandwastewatersamples AT annclairegourinat ertapenemsupplementedselectivemediaasanewstrategytodistinguishblactamresistantenterobacteralesapplicationtoclinicalandwastewatersamples AT cyrillegoarant ertapenemsupplementedselectivemediaasanewstrategytodistinguishblactamresistantenterobacteralesapplicationtoclinicalandwastewatersamples AT juliencolot ertapenemsupplementedselectivemediaasanewstrategytodistinguishblactamresistantenterobacteralesapplicationtoclinicalandwastewatersamples |