Evaluation of CARBA PAcE, a novel rapid test for detection of carbapenemase-producing Open Access

Abstract

Carbapenemase-producing (CPE) are an increasing threat to global health. Fast detection is crucial for patient management and outbreak control.

Recently, a new commercial colorimetric test, CARBA PAcE, was released that has not yet been scientifically evaluated.

Our goals were to evaluate the performance of CARBA PAcE using a large variety of different CPE.

CARBA PAcE was challenged with 107 molecularly characterized CPE and 53 non-CPE controls. Isolates were grown on Mueller-Hinton agar (MHA); in the case of a false-negative result, isolates were additionally inoculated on Columbia blood agar (CBA) and CARBA PAcE was repeated. The test was performed according to the manufacturer’s protocol.

CARBA PAcE showed an overall sensitivity and specificity of 72 % [confidence interval (CI) 62–80 %] and 91 % (CI 79–97 %), respectively, when isolates were grown on MHA. With growth on CBA, detection improved (especially of metallo-β-lactamases), resulting in an extrapolated sensitivity of 89 % (CI 81–94 %) for all carbapenemases and 96 % (CI 89–99 %) for the four major carbapenemases (NDM, OXA-48-like, KPC, VIM).

CARBA PAcE is a simple and very rapid test for the detection of CPE which performs well for the major carbapenemases when isolates are grown on CBA. Laboratories should be aware of the limitations of this assay, such as moderate sensitivity when isolates are grown on more challenging agars such as MHA and the poor detection of some rare carbapenemases (e.g. IMI, OXA-58).

Funding
This study was supported by the:
  • Deutsches Zentrum für Infektionsforschung
    • Principle Award Recipient: AxelHamprecht
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/content/journal/jmm/10.1099/jmm.0.001290
2020-12-03
2024-03-28
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References

  1. van Duin D, Doi Y. The global epidemiology of carbapenemase-producing Enterobacteriaceae . Virulence 2017; 8:460–469 [View Article][PubMed]
    [Google Scholar]
  2. Falagas ME, Lourida P, Poulikakos P, Rafailidis PI, Tansarli GS. Antibiotic treatment of infections due to carbapenem-resistant Enterobacteriaceae: systematic evaluation of the available evidence. Antimicrob Agents Chemother 2014; 58:654–663 [View Article][PubMed]
    [Google Scholar]
  3. Nordmann P, Naas T, Poirel L. Global spread of carbapenemase-producing Enterobacteriaceae . Emerg Infect Dis 2011; 17:1791–1798 [View Article][PubMed]
    [Google Scholar]
  4. French CE, Coope C, Conway L, Higgins JPT, McCulloch J et al. Control of carbapenemase-producing Enterobacteriaceae outbreaks in acute settings: an evidence review. J Hosp Infect 2017; 95:3–45 [View Article][PubMed]
    [Google Scholar]
  5. Baeza LL, Pfennigwerth N, Greissl C, Göttig S, Saleh A et al. Comparison of five methods for detection of carbapenemases in Enterobacterales with proposal of a new algorithm. Clin Microbiol Infect 2019; 25:1286.e9–121286 [View Article]
    [Google Scholar]
  6. Tamma PD, Opene BNA, Gluck A, Chambers KK, Carroll KC et al. Comparison of 11 phenotypic assays for accurate detection of carbapenemase-producing Enterobacteriaceae . J Clin Microbiol 2017; 55:1046–1055 [View Article][PubMed]
    [Google Scholar]
  7. Nordmann P, Poirel L, Dortet L. Rapid detection of carbapenemase-producing Enterobacteriaceae . Emerg Infect Dis 2012; 18:1503–1507 [View Article][PubMed]
    [Google Scholar]
  8. Workneh M, Yee R, Simner PJ. Phenotypic methods for detection of carbapenemase production in carbapenem-resistant organisms: what method should your laboratory choose?. Clin Microbiol Newsl 2019; 41:11–22 [View Article]
    [Google Scholar]
  9. Lucena Baeza L, Pfennigwerth N, Hamprecht A. Rapid and easy detection of carbapenemases in Enterobacterales in the routine laboratory using the new GenePOC Carba/Revogene Carba C assay. J Clin Microbiol 2019; 57:e00597–19 [View Article][PubMed]
    [Google Scholar]
  10. Noël A, Huang T-D, Berhin C, Hoebeke M, Bouchahrouf W et al. Comparative evaluation of four phenotypic tests for detection of carbapenemase-producing Gram-negative bacteria. J Clin Microbiol 2017; 55:510–518 [View Article][PubMed]
    [Google Scholar]
  11. Dortet L, Bréchard L, Poirel L, Nordmann P. Impact of the isolation medium for detection of carbapenemase-producing Enterobacteriaceae using an updated version of the Carba NP test. J Med Microbiol 2014; 63:772–776 [View Article][PubMed]
    [Google Scholar]
  12. Saleh A, Göttig S, Hamprecht AG. Multiplex immunochromatographic detection of OXA-48, KPC, and NDM carbapenemases: impact of inoculum, antibiotics, and agar. J Clin Microbiol 2018; 56:e00050–18 [View Article][PubMed]
    [Google Scholar]
  13. Greissl C, Saleh A, Hamprecht A. Rapid detection of OXA-48-like, KPC, NDM, and VIM carbapenemases in Enterobacterales by a new multiplex immunochromatographic test. Eur J Clin Microbiol Infect Dis 2019; 38:331–335 [View Article][PubMed]
    [Google Scholar]
  14. Rasmussen BA, Bush K, Keeney D, Yang Y, Hare R et al. Characterization of IMI-1 beta-lactamase, a class A carbapenem-hydrolyzing enzyme from Enterobacter cloacae . Antimicrob Agents Chemother 1996; 40:2080–2086 [View Article][PubMed]
    [Google Scholar]
  15. Bernabeu S, Dortet L, Naas T. Evaluation of the β-CARBA test, a colorimetric test for the rapid detection of carbapenemase activity in gram-negative bacilli. J Antimicrob Chemother 2017; 72:1646–1658 [View Article][PubMed]
    [Google Scholar]
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