Assessment of a newly developed immunochromatographic assay for NDM-type metallo-β-lactamase producing Gram-negative pathogens in Myanmar

Abstract

Background To detect carbapenemase-producing Gram-negative bacteria in bacterial laboratories at medical settings, a new immunochromatographic assay for New Delhi metallo-β-lactamases (NDMs) was developed. Methods The immunochromatographic assay for New Delhi metallo-β-lactamases producers was developed using rat monoclonal antibodies against NDMs. The assessment was performed using 350 isolates of Gram-negative bacteria, including Acinetobacter baumannii (51 isolates), Enterobacteriaceae (163 isolates), and Pseudomonas aeruginosa (136 isolates) obtained from 2015 to 2017 in medical settings in Myanmar. Of them, 302 isolates were resistant to carbapenems, including imipenem and/or meropenem. The bla NDM genes were identified by PCR and sequencing. Results Of the 350 clinical isolates tested, 164 (46.9%) (60 isolates of Escherichia coli , 51 isolates of Klebsiella pneumoniae , 25 isolates of Enterobacter cloacae , 23 isolates of P. aeruginosa , and 5 isolates of A. baumannii ) were positive on this assay, and all the positive isolates harbored genes encoding NDM-1, − 4, − 5 and − 7. The remaining 186 (53.1%) isolates negative on the assay did not harbor genes encoding NDMs. The assay had a specificity of 100% and a sensitivity of 100%. The assessment revealed that more than 90% of carbapenem-resistant Enterobacteriaceae produced NDMs. Conclusions The immunochromatographic assay is an easy-to-use and reliable kit for detection of NDMs-producing Gram-negative bacteria. The assay revealed that NDM-producing Enterobacteriaceae isolates are wide-spread in medical settings in Myanmar. Electronic supplementary material The online version of this article (10.1186/s12879-019-4147-4) contains supplementary material, which is available to authorized users.

Emergence of Carbapenem-Resistant Pseudomonas asiatica Producing NDM-1 and VIM-2 Metallo-β-Lactamases in Myanmar

“…Detection of carbapenemases. Carbapenemase production was detected with the CIMTrisII carbapenem inactivation method (Kohjin Bio, Saitama, Japan) (20), and NDM-type MBL production was detected using a KBM LineCheck NDM immunochromatographic assay (Kojin Bio) (21).…”

Innovative and rapid antimicrobial susceptibility testing systems

“…The interaction between the antibodies and resistance enzymes requires optimization, but several lateral flow assays (LFAs) have been developed for the detection of β lactamases 72 . An LFA specific to New Delhi metallo βlactamase (NDM) 1 was 100% sensitive and specific in a collection of 350 isolates from Myanmar 73 . Similar performance was established for a combined LFA that detected OXA48, IMP, NDM and VIM enzymes 74 .…”

Emergence of NDM-1- and CTX-M-3-Producing Raoultella ornithinolytica in Human Gut Microbiota

“…Carbapenem-resistant Enterobacteriaceae (CRE) is a serious public health concern worldwide because of its rapid spread and limited therapeutic drugs (Zheng et al, 2018). Metallo-β-lactamases (MBLs) are produced by many species of Gram-negative bacteria and confer resistance to carbapenems, cephalosporins, and penicillins except monobactams (Tada et al, 2019). New Delhi Metallo-beta-Lactamase 1 (NDM-1) is a plasmid-associated Ambler class B β-lactamase/carbapenemase that was first reported in clinical E. coli and Klebsiella pneumoniae isolates from an Indian patient in Sweden in 2008 (Yong et al, 2009).…”