Korean J healthc assoc Infect Control Prev.  2023 Jun;28(1):42-49. 10.14192/kjicp.2023.28.1.42.

Laboratory Diagnosis of Carbapenemase-producing Enterobacterales

Affiliations
  • 1Department of Laboratory Medicine, Seoul Metropolitan Government Boramae Hospital, Seoul, Korea
  • 2Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
  • 3Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
  • 4Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
  • 5Department of Laboratory Medicine, National Health Insurance Service, Ilsan Hospital, Goyang, Korea

Abstract

Carbapenem-resistant enterobacterales (CREs) are pathogens of special concern in healthcareassociated infections. Enterobacterales become resistant to carbapenems through several mechanisms, including carbapenemase enzyme production. Enterobacterales that produce carbapenemase are known as carbapenemase-producing enterobacterales (CPEs). Genes encoding carbapenemase are usually found on plasmids that can transmit horizontally between strains, which could explain the rapid spread of carbapenem resistance. Timely and accurate laboratory tests of CPE are necessary to prevent and treat these infections. Various phenotypic tests, such as the modified Hodge test, modified carbapenem inactivation method (mCIM) with or without EDTA-CIM (eCIM), chromogenic agar test, carba NP, immunoassay, mass spectrometry, and molecular tests are available. In this study, we discussed the importance of CRE and CPE control in the COVID-19 pandemic era and summarized several laboratory CPE detection methods currently utilized in clinical microbiology laboratories.

Keyword

Carbapenem-resistant Enterobacterales; Carbapenemase-producing Enterobacterales; Laboratory diagnosis; Phenotypic test; Molecular test

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