RESUMO
A semiautomated, repetitive-sequence-based PCR (rep-PCR) instrument (DiversiLab system) was evaluated in comparison with pulsed-field gel electrophoresis (PFGE) to investigate an outbreak of Serratia marcescens infections in a neonatal intensive care unit (NICU). A selection of 36 epidemiologically related and 8 epidemiologically unrelated isolates was analyzed. Among the epidemiologically related isolates, PFGE identified five genetically unrelated patterns. Thirty-two isolates from patients and wet nurses showed the same PFGE profile (pattern A). Genetically unrelated PFGE patterns were found in one patient (pattern B), in two wet nurses (patterns C and D), and in an environmental isolate from the NICU (pattern G). Rep-PCR identified seven different patterns, three of which included the 32 isolates of PFGE type A. One or two band differences in isolates of these three types allowed isolates to be categorized as similar and included in a unique cluster. Isolates of different PFGE types were also of unrelated rep-PCR types. All of the epidemiologically unrelated isolates were of different PFGE and rep-PCR types. The level of discrimination exhibited by rep-PCR with the DiversiLab system allowed us to conclude that this method was able to identify genetic similarity in a spatio-temporal cluster of S. marcescens isolates.
Assuntos
Técnicas de Tipagem Bacteriana/métodos , Infecção Hospitalar/epidemiologia , Surtos de Doenças , Eletroforese em Gel de Campo Pulsado/métodos , Reação em Cadeia da Polimerase/métodos , Infecções por Serratia/epidemiologia , Serratia marcescens/classificação , Adulto , Automação/métodos , Análise por Conglomerados , Infecção Hospitalar/microbiologia , DNA Bacteriano/genética , Microbiologia Ambiental , Genótipo , Mãos/microbiologia , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Itália/epidemiologia , Epidemiologia Molecular , Enfermeiras e Enfermeiros , Sequências Repetitivas de Ácido Nucleico , Infecções por Serratia/microbiologia , Serratia marcescens/genética , Serratia marcescens/isolamento & purificaçãoRESUMO
A total of 78 isolates of Pseudomonas aeruginosa grouped according to the phenotype for ceftazidime and imipenem susceptibility/resistance were used to assess the accuracy of the Vitek 2 system in antimicrobial susceptibility testing. Comparisons were made with a MIC gradient test for piperacillin-tazobactam, ceftazidime, aztreonam, imipenem, meropenem, gentamicin, and ciprofloxacin. For the total of 546 isolate-antimicrobial combinations tested, the category agreement was 83.6%, with 2.0, 1.6, and 12.8% very major, major, and minor errors, respectively. Vitek 2 accuracy was influenced differently by the mechanism responsible for resistance, and interpretation of the results in relation to phenotype could improve the performance of the system.