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DOI: 10.4103/JLP.JLP_138_16
Simple, rapid, and cost-effective modified Carba NP test for carbapenemase detection among Gram-negative bacteria
Financial support and sponsorship: Nil.Abstract
PURPOSE: Detection of carbapenemases among Gram-negative bacteria (GNB) is important for both clinicians and infection control practitioners. The Clinical and Laboratory Standards Institute recommends Carba NP (CNP) as confirmatory test for carbapenemase production. The reagents required for CNP test are costly and hence the test cannot be performed on a routine basis. The present study evaluates modifications of CNP test for rapid detection of carbapenemases among GNB.
MATERIALS AND METHODS: The GNB were screened for carbapenemase production using CNP, CarbAcineto NP (CANP), and modified CNP (mCNP) test. A multiplex polymerase chain reaction (PCR) was performed on all the carbapenem-resistant bacteria for carbapenemase genes. The results of three phenotypic tests were compared with PCR.
RESULTS: A total of 765 gram negative bacteria were screened for carbapenem resistance. Carbapenem resistance was found in 144 GNB. The metallo-β-lactamases were most common carbapenemases followed by OXA-48-like enzymes. The CANP test was most sensitive (80.6%) for carbapenemases detection. The mCNP test was 62.1% sensitive for detection of carbapenemases. The mCNP, CNP, and CANP tests were equally sensitive (95%) for detection of NDM enzymes among Enterobacteriaceae. The mCNP test had poor sensitivity for detection of OXA-48-like enzymes.
CONCLUSION: The mCNP test was rapid, cost-effective, and easily adoptable on routine basis. The early detection of carbapenemases using mCNP test will help in preventing the spread of multidrug-resistant organisms in the hospital settings.
Key words
Carbapenemases - Carba NP test - CarbAcineto NP test - carbapenem-resistant organisms - metallo-β-lactamasePublication History
Received: 11 October 2016
Accepted: 14 March 2017
Article published online:
19 February 2020
© 2017.
Thieme Medical and Scientific Publishers Private Ltd.
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References
- 1 Nordmann P, Poirel L, Dortet L. Rapid detection of carbapenemase-producing Enterobacteriaceae. Emerg Infect Dis 2012;18:1503-7.
- 2 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;57:4578-80.
- 3 Nordmann P, Naas T, Poirel L. Global spread of carbapenemase-producing Enterobacteriaceae. Emerg Infect Dis 2011;17:1791-8.
- 4 Dortet L, Agathine A, Naas T, Cuzon G, Poirel L, Nordmann P. Evaluation of the RAPIDEC® CARBA NP, the Rapid CARB Screen® and the carba NP test for biochemical detection of carbapenemase-producing Enterobacteriaceae. J Antimicrob Chemother 2015;70:3014-22.
- 5 Osterblad M, Hakanen AJ, Jalava J. Evaluation of the Carba NP test for carbapenemase detection. Antimicrob Agents Chemother 2014;58:7553-6.
- 6 Vasoo S, Cunningham SA, Kohner PC, Simner PJ, Mandrekar JN, Lolans K, et al. 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. J Clin Microbiol 2013;51:3097-101.
- 7 Clinical and Laboratory Standards Institute. M100-S25. Performance standards for antimicrobial susceptibility testing; 25th informational supplement. Wayne, PA: CLSI; 2015.
- 8 Dortet L, Poirel L, Errera C, Nordmann P. CarbAcineto NP test for rapid detection of carbapenemase-producing Acinetobacter spp. J Clin Microbiol 2014;52:2359-64.
- 9 Clinical and Laboratory Standards Institute. M7-A9. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically. 9th ed. Wayne, PA: CLSI; 2012.
- 10 Black JA, Moland ES, Thomson KS. AmpC disk test for detection of plasmid-mediated AmpC beta-lactamases in Enterobacteriaceae lacking chromosomal AmpC beta-lactamases. J Clin Microbiol 2005;43:3110-3.
- 11 Holland KT, Cunliffe WJ, Eady EA. Intergeneric and intrageneric inhibition between strains of Propionibacterium acnes and Micrococcaceae, particularly Staphylococcus epidermidis, isolated from normal skin and acne lesions. J Med Microbiol 1979;12:71-82.
- 12 Chen L, Mediavilla JR, Endimiani A, Rosenthal ME, Zhao Y, Bonomo RA, et al. Multiplex real-time PCR assay for detection and classification of Klebsiella pneumoniae carbapenemase gene (blaKPC) variants. J Clin Microbiol 2011;49:579-85.
- 13 Pasteran F, Tijet N, Melano RG, Corso A. Simplified protocol for Carba NP test for enhanced detection of carbapenemase producers directly from bacterial cultures. J Clin Microbiol 2015;53:3908-11.
- 14 Pasteran F, Veliz O, Ceriana P, Lucero C, Rapoport M, Albornoz E, et al. Evaluation of the Blue-Carba test for rapid detection of carbapenemases in Gram-negative bacilli. J Clin Microbiol 2015;53:1996-8.
- 15 Garg A, Garg J, Upadhyay GC, Agarwal A, Bhattacharjee A. Evaluation of the Rapidec Carba NP test kit for detection of carbapenemase-producing Gram-negative bacteria. Antimicrob Agents Chemother 2015;59:7870-2.