Ann Clin Microbiol.  2021 Jun;24(2):45-53. 10.5145/ACM.2021.24.2.2.

Evaluation of Two Commercial Kits for Rapid Detection and Typing of Carbapenemase in Carbapenem-Resistant Enterobacterales

• Lee S
• Hur KH
• Chung Y
• Sung H
• Kim MN

• KMID: 2516725
• DOI: http://doi.org/10.5145/ACM.2021.24.2.2

Abstract

Background
Rapid detection of carbapenemase-producing Enterobacterales (CPE) is desirable to guide antimicrobial therapy and infection control. The NG-Test Carba5 (Carba5;NG Biotech, France) rapid multiplex lateral flow immunoassay and BD MAX Check-Points CPO Assay (CPO; BD Diagnostic Systems, USA) fully automated real-time PCR assay were evaluated for the detection of KPC, NDM, VIM, IMP, and OXA-48-like group in a culture colony compared to genotyping using conventional PCR.
Methods
Among the clinical isolates of carbapenem-resistant Enterobacterales (CRE) collected from 2013 to 2019, up to 20 isolates for each carbapenemase type, and approximately 60 carbapenemase-negative CRE were enrolled. Genotyping of carbapenemases were performed using single-target PCR for KPC, NDM, and OXA-48-like group and the multiplex PCR for VIM, IMP, GIM, SIM, and SPM. All isolates were tested with Carba5 and CPO. The discrepant results were resolved by single-target specific conventional PCR or GeneXpert Carba-R Assay (Carba-R; Cepheid, USA).
Results
Of 147 CREs, 82 were CPE (55.8%) including 20 KPC, 22 NDM, 17 VIM, three IMP, and 13 OXA-48-like group, and seven double carbapenemase-positive (three KPC/VIM, two NDM/ VIM, one KPC/NDM, and one NDM/OXA-48-like group) isolates. Carba5 and CPO detected all CPE correctly along with two more IMP-producing CPE. The sensitivity and specificity of both kits were equally 100% and 97%. Two false IMP-positives were confirmed IMP-positive with Carba-R and IMP-specific single-target PCR.
Conclusion
Carba5 and CPO reliably detect and differentiate five common carbapenemases in cultured colonies. Carba5, faster and simpler, is preferred as a spot test.

Keyword

Carbapenemase; Enterobacterales; Genotype; Immunoassay; PCR

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