1887

Abstract

Carbapenemase-producing organisms (CPOs) can be resistant to almost all β-lactams and represent an increasing threat in healthcare facilities. Detection of these organisms in routine diagnostic laboratories is difficult; here we evaluate four commercially available CPO detection assays and assess their suitability for the clinical laboratory.

A panel of 95 clinical multidrug-resistant organisms (22 NDM, 24 OXA-48, 19 VIM, 4 OXA-23, 3 KPC, 4 NDM+OXA-48, 1 OXA23+NDM, 1 IMI, 1 IMP-1, 9 ESBL, 3 derepressed AmpC and 4 inducible AmpC producers) were tested by the RESIST-3 O.K.N., RapidEC CarbaNP, Acuitas Resistome and Xpert Carba-R assays.

The commercial assays performed well, with high sensitivities (96.2–100 %) and specificities (all, 100 %). The RapidEC CarbaNP and Acuitas Resistome were able to detect the broadest range of carbapenemase genotypes. The RESIST-3 O.K.N. and Xpert CarbaR had the shortest turnaround times, whilst the RapidEC CarbaNP was the only assay included in this study that could detect previously undescribed genotypes.

Using an algorithm of the RapidEC CarbaNP, followed by either the RESIST-3 O.K.N. () or the Xpert Carba-R ( and spp.) on suspect CPOs allowed rapid in-house detection and genotyping of a high proportion of CPOs, reducing turnaround time by up to 7 days.

Keyword(s): algorithm , Carbapenemase and detection
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2018-02-01
2024-03-29
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References

  1. Poirel L, Pitout JD, Nordmann P. Carbapenemases: molecular diversity and clinical consequences. Future Microbiol 2007; 2:501–512 [View Article][PubMed]
    [Google Scholar]
  2. Chang YY, Chuang YC, Siu LK, Wu TL, Lin JC et al. Clinical features of patients with carbapenem nonsusceptible Klebsiella pneumoniae and Escherichia coli in intensive care units: a nationwide multicenter study in Taiwan. J Microbiol Immunol Infect 2015; 48:219–225 [View Article][PubMed]
    [Google Scholar]
  3. Otter JA, Burgess P, Davies F, Mookerjee S, Singleton J et al. Counting the cost of an outbreak of carbapenemase-producing Enterobacteriaceae: an economic evaluation from a hospital perspective. Clin Microbiol Infect 2017; 23:188–196 [View Article][PubMed]
    [Google Scholar]
  4. Jeon JH, Lee JH, Lee JJ, Park KS, Karim AM et al. Structural basis for carbapenem-hydrolyzing mechanisms of carbapenemases conferring antibiotic resistance. Int J Mol Sci 2015; 16:9654–9692 [View Article][PubMed]
    [Google Scholar]
  5. Glasner C, Albiger B, Buist G, Tambić Andrasević A, Canton R et al. European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE) working group. Carbapenemase-producing Enterobacteriaceae in Europe: assessment by national experts from 38 countries. Euro Surveill 2015; 20:45
    [Google Scholar]
  6. Lutgring JD, Limbago BM. The problem of carbapenemase-producing-carbapenem-resistant-Enterobacteriaceae detection. J Clin Microbiol 2016; 54:529–534 [View Article][PubMed]
    [Google Scholar]
  7. Wilkinson KM, Winstanley TG, Lanyon C, Cummings SP, Raza MW et al. Comparison of four chromogenic culture media for carbapenemase-producing Enterobacteriaceae. J Clin Microbiol 2012; 50:3102–3104 [View Article][PubMed]
    [Google Scholar]
  8. Girlich D, Poirel L, Nordmann P. Comparison of the SUPERCARBA, CHROMagar KPC, and Brilliance CRE screening media for detection of Enterobacteriaceae with reduced susceptibility to carbapenems. Diagn Microbiol Infect Dis 2013; 75:214–217 [View Article][PubMed]
    [Google Scholar]
  9. Viau R, Frank KM, Jacobs MR, Wilson B, Kaye K et al. Intestinal carriage of carbapenemase-producing organisms: current status of surveillance methods. Clin Microbiol Rev 2016; 29:1–27 [View Article][PubMed]
    [Google Scholar]
  10. Calderaro A, Buttrini M, Piergianni M, Montecchini S, Martinelli M et al. Evaluation of a modified meropenem hydrolysis assay on a large cohort of KPC and VIM carbapenemase-producing Enterobacteriaceae. PLoS One 2017; 12:4 [View Article][PubMed]
    [Google Scholar]
  11. Tijet N, Boyd D, Patel SN, Mulvey MR, Melano RG. Evaluation of the Carba NP test for rapid detection of carbapenemase-producing Enterobacteriaceae and Pseudomonas aeruginosa. Antimicrob Agents Chemother 2013; 57:4578–4580 [View Article][PubMed]
    [Google Scholar]
  12. Acute Trust Toolkit for the Early Detection, Management and Control of Carbapenemase-Producing enterobacteriaceae Public Health England; 2013
    [Google Scholar]
  13. Findlay J, Hopkins KL, Meunier D, Woodford N. Evaluation of three commercial assays for rapid detection of genes encoding clinically relevant carbapenemases in cultured bacteria. J Antimicrob Chemother 2015; 70:1338–1342 [View Article][PubMed]
    [Google Scholar]
  14. Hombach M, von Gunten B, Castelberg C, Bloemberg GV. Evaluation of the Rapidec Carba NP test for detection of carbapenemases in Enterobacteriaceae. J Clin Microbiol 2015; 53:3828–3833 [View Article][PubMed]
    [Google Scholar]
  15. Kost K, Yi J, Rogers B, Jerris R. Comparison of clinical methods for detecting carbapenem-resistant Enterobacteriaceae. Pract Lab Med 2017; 8:18–25 [View Article][PubMed]
    [Google Scholar]
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