Detection of Carbapenemase Production in Klebsiella pneumoniae Isolates by Rapid Carbapenemase Detection Method in an OXA-48 Endemic Region

Abstract

Background: Carbapenem resistance is one of the major global public health threats caused by the overuse or misuse of carbapenems, which are often the last resort in treating multidrug-resistant infections. Today, timely detection of carbapenemase-producing organisms is critical for infection control. Therefore, rapid and accurate detection of carbapenemases using a cost-effective method with high sensitivity and specificity is essential to guide appropriate treatment and prevent further spread. Objectives: This study aimed to evaluate the sensitivity of the newly developed rapid carbapenemase detection method (rCDM) with isolates whose resistance genes were determined by molecular methods and to compare it with the modified carbapenem inactivation method (mCIM), whose diagnostic performance characteristics are well-defined. Methods: A total of 130 Klebsiella pneumoniae isolates (65 carbapenem-susceptible, 65 carbapenem-resistant) from various clinical specimens were included in the study. Identification and antibiotic susceptibility testing of the isolates was performed using the BD Phoenix™ automated system. Phenotypic carbapenemase detection methods, mCIM and rCDM, were studied for all carbapenem-sensitive and carbapenem-resistant isolates with known resistance genes. Results: Among carbapenem-resistant K. pneumoniae isolates, blaOXA-48 was the most frequently detected resistance gene (78%). Using PCR results as the reference method, the sensitivity of rCDM was 100%. When rCDM and mCIM results were compared, both phenotypic methods were 100% compatible, with no statistically significant difference observed. Conclusions: Rapid carbapenemase detection method is a rapid and reliable phenotypic carbapenemase detection method with high sensitivity. Its ease of use and interpretation make it suitable for use in laboratories with limited resources. Additionally, its excellent performance in detecting common carbapenemase types and high consistency with mCIM support its utility in various laboratory settings without requiring additional materials or technical infrastructure.