Carba NP Test as a Rapid Diagnostic Tool for Carbapenemase Producers

Title: Carba NP Test as a Rapid Diagnostic Tool for Carbapenemase Producers

Authors: Dalia H Abd El Hamid, Sherin Ahmed EL-Masry, Amira Mohamed Mokhtar, Eman Mohamed Kamel

DOI: https://dx.doi.org/10.18535/jmscr/v5i3.131

Abstract

The increasing resistance to carbapenems is a worldwide clinical concern. Resistance is mainly due to carbapenemases, which hydrolyse most β-lactams. Carbapenemases are found on diverse mobile genetic elements that may carry multiple resistance genes, leading to resistance to many antibiotic classes. Because of the complexity and diversity of carbapenem resistance mechanisms, particularly carbapenemase- mediated resistance, rapid and accurate detection is necessary to inform appropriate therapy. Carba NP and CarbAcineto NP tests are biochemical tests with relatively high sensitivities and specificities and faster turnaround times than culture based methods. The aim of this work is to detect the ability of Carba NP test to rapidly identify carbapenemase producing isolates. During this study, 100 carbapenem-resistant gram-negative isolates were subjected to Carba NP or CarbAcineto NP tests, subcultured on CHROMagar KPC media and tested by PCR for bla_KPC, bla_VIM, bla_OXA, bla_GES, bla_IMP.94/100 (94%) isolates were positive for carbapenemase production by both Carba NP and CarbAcineto NP tests. 100/100 (100%) were positive by CHRM agar KPC. 94/100 (94%) isolates were positive for carbapenemase production by PCR. Carba NP test showed a sensitivity, specificity, PPV and NPV of 100% compared to PCR in Enterobacteriaceae and Pseudomonas spp. CarbAcineto NP test showed a sensitivity, specificity, PPV and NPV of 100% compared to PCR in Acinetobacterspp. CHRO Magar KPC test showed a sensitivity, specificity and PPV of 100%, 0%, and 94% respectively compared to PCR. In conclusion, Carba NP and CarbAcineto NP tests are highly sensitive and specific, cheap, rapid tests for the detection of carbapenemase production.

Keywords: Carba NP test, KPC, CHROMagar KPC, CarbAcineto NP, Carbapenem.

References

1. Voulgari E, Poulou A, Koumaki V, et al., (2013): Carbapenemase-producing Entero-bacteriaceae: now that the storm is finally here, how will timely detection help us fight back? Future Microbiology; 8(1): 27-39.

2. Nass T, Cuzon G, Bogaerts P, et al., (2011): Evaluation of a DNA Microarray (Check-MDR CT102) for Rapid Detection of TEM, SHV, and CTX-M Extended-Spectrum β-Lactamases and of KPC, OXA-48, VIM, IMP, and NDM-1Carbapenemases. Journal of Clinical Microbiology; 49(4): 1608-1613.

3. Wang L, Gu H and Lu X (2012): Rapid low-cost detection of Klebsiellapneu-moniae carbapenemase genes by internally controlled real-time PCR. Journal of Microbiological Methods; 91: 361-363.

4. Pragasam AK, Sahni RD, Anandan S, et al., (2016): A Pilot Study on Carbapenemase Detection: Do We See the Same Level of Agreement as with the CLSI Observations. Journal of Clinical and Diagnostic Research; 10(7): DC09-DC13.

5. Nordmann P, Poirel L, Toleman MA, et al., (2011): Does broad-spectrum beta-lactam resistance due to NDM-1 herald the end of the antibiotic era for treatment of infections caused by Gram-negative bacteria? Journal of Antimicrobial Chemotherapy; 66(4): 689-92.

6. Nordmann P, Gniadkowski M, Giske CG, et al. (2012): Identification and screening of Carbapenemase-producing Enterobact-eriaceae. Clinical Microbiology and Infection; 18(5): 432-438.

7. Calfee D and Jenkins SG (2008): Use of active surveillance cultures to detect asymptomatic colonization with carbap-enem-resistant Klebsiellapneumoniae in intensive care unit patients. Infection Control Hospital Epidemiology;29(10): 966-968.

8. Vrioni G, Daniil I,Voulgari E, et al. (2012): Comparative evaluation of a prototype chromogenic medium (ChromID CARBA) for detecting carbapenemase-producing Enterobacteriaceaein surveillance rectal swabs. Journal of Clinical Microbiology; 50(6): 1841-1846.

9. Simner PJ, Gilmour MW, DeGagne P, et al. (2015): Evaluation of Five Chromo-genic Agar Media and the Rosco Rapid Carb Screen Kit for Detection and Confirmation of Carbapenemase Produc-tion in Gram-Negative Bacilli. Journal of Clinical Microbiology; 53(1): 105-112.

10. Chen L, Mediavalla JR, Endimiani A et al. (2011): Multiplex real-time PCR assay for detection and classification of Klebsiellapneumoniae carbapenemases gene (bla_KPC) variants. Journal of Clinical Microbiology; 49: 579-585.

11. Sekyere JO, Govinden U and Essack SY (2015): Review of established and innovative detection methods for carbapenemase-producing Gram-negative bacteria. Journal of Applied Microbiology; 119: 1219-1233.

12. Nordmann P, Poirel L and Dortet L (2012): Rapid detection of carbapenemase-producing Enterobacteriaceae. Emerging Infectious Disease; 18(9): 1503-1507.

13. Dortet L, Poirel L, Errera C and Nordmann P (2014): CarbAcineto NP Test for Rapid Detection of Carbapenemase- Producing Acinetobacter spp. Journal of Clinical Microbiology; 52 (7): 2359-2364.

14. Panagea T, Galani I, Souli M, et al., (2011): Evaluation of CHROMagar KPC for the detection of Carbapenemase- producing Enterobacteriaecein Rectal Surveillance Culture. International journal of antimicrobial agents; 37(2): 124-128.

15. Monterio J, Widen R, Pignatari A, et al., (2012): Rapid detection of carbapenemase genes by multiplex real-time PCR. Journal of Antimicrobial Chemotherapy; 67(4): 906-909.

16. Vasoo S, Cunningham SA, Peggy C Kohner PC, et al., (2013): Comparison of a Novel, Rapid Chromogenic Biochemical Assay, the Carba NP Test, with the Modified Hodge Test for Detection of Carbapenemase-Producing Gram-Negative Bacilli. Journal of Clinical Microbiology; 51(9): 3097-3101.

17. Tijet N, Boyd D, Patel SN, et al., (2013): Evaluation of the Carba NP Test for Rapid Detection of Carbapenemase-Producing Enterobacteriaceae and Pseudomonas aeruginosa. Antimicrobial Agents and Chemotherapy; 57(9): 4578-4580.

18. Yusuf E, Van Der Meeren S, Schallier A, et al.,(2014): Comparison of the Carba NP test with the Rapid CARB Screen Kit for the detection of carbapenemase-producing Enterobacteriaceae and Pseudomonas aeruginosa. European Journal of Clinical Microbiology and Infectious Diseases; 33: 2237-2240.

19. Knox J, Jadhav S, Sevior D, et al., (2014): Phenotypic Detection of Carbapenemase Producing Enterobacteriaceae by Use of Matrix-Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry and the Carba NP Test. Journal of Clinical Microbiology; 52(11): 4075-4077.

20. Osterblad M, Hakanen AJ and Jalava J (2014): Evaluation of the Carba NP test for carbapenemase detection. Antimicrobial Agents and Chemotherapy; 58: 7553-7556.

21. AbdelGhani S, Thomson GK, Snyder JW, et al., (2015): Comparison of the Carba NP, modified Carba NP, and updated Rosco Neo-Rapid Carb kit tests for carbapenemase detection. Journal of Clinical Microbiology; 53: 3539-3542.

22. Srisrattakarn A, Lulitanond A, Wilailu-ckana C, et al., (2016): Modification and evaluation of the Carba NP test by use of paper strip for simple and rapid detection of carbapenemase-producing Enterobact-eriaceae. World Journal of Microbiology and Biotechnology; 32(7): 117.

23. Dortet L, Poirel L and Nordmann P (2012): Rapid Detection of Carbapenemase-Producing Pseudomonas spp. Journal of Clinical Microbiology; 50(11): 3773-3776.

24. Huang T, Berhin C, Bogaerts P, et al., (2014): Comparative Evaluation of Two Chromogenic Tests for Rapid Detection of Carbapenemase in Enterobacteriaceaeand in Pseudomonas aeruginosa Isolates. Journal of Clinical Microbiology; 52(8): 3060-3063.

25. Heinrichs A, Huang TD, Berhin C, et al., (2015): Evaluation of several phenotypic methods for the detection of carbapenemase-producing Pseudomonas aeruginosa. European Journal of Clinical Microbiology and Infectious Diseases; 34(7): 1467-1474.

26. Adler A, Navon-Venezia S, Moran-Gilad J, et al., (2011): Laboratory and clinical evaluation of screening agar plates for detection of carbapenem-resistant Enterobacteriaceae from surveillance rectal swabs. Journal of Clinical Microbiology;49:2239–2242.

27. Samra Z, Bahar J, Madar-Shapiro L, et al. (2008): Evaluation of CHROMagar KPC for Rapid Detection of Carbapenem-Resistant Enterobacteriaceae. Journal of Clinical Microbiology; 46(9): 3110-3111.

28. Gilad JM, Carmeli V, Schwartz D, Navon-Venezia S(2011): Laboratory evaluation of the CHROMagar KPC medium for identification of carbapenem-non susceptible Enterobacteriaceae. Diagnostic microbiology and infectious disease ;70(4):565-567.

Dalia Hosni Abd El Hamid

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Phone number: 00201223719886

Present Address: 11 Elgolf Street, 5thSettlment, New Cairo, Cairo, Egypt

Abstract

References

Corresponding Author

Call For Paper Volume 12 Issue 12 December 2024

JMSCR Menu

Impact Factor SJIF 2024: 7.892

Crossref - DOI

Editorial Policy

Frequency of Publication

Submission of Articles

Search

Abstract

Call For Paper Volume 12 Issue 12 December 2024

JMSCR Menu

Impact Factor SJIF 2024: 7.892

Crossref - DOI

Editorial Policy

Frequency of Publication

Submission of Articles