Multiplex lateral flow immunochromatographic assay is an effective method to detect carbapenemases without risk of OXA-48-like cross reactivity

Abstract

Background It is essential to detect carriers of carbapenemase-producing Enterobacterales in order to implement infection control measures. The objectives of this study was to evaluate the NG-Test® CARBA 5 (CARBA 5) assay for detection of five carbapenemases and to assess the cross reactivity of other OXA-type carbapenemases with the OXA-48-like specific antibodies. Methods A total of 197 Enterobacterales isolates were tested. To evaluate the cross reactivity, 73 carbapenem-resistant A. baumannii, harboring OXA-type variants, were tested. Polymerase chain reaction (PCR) served as gold standard for carbapenemase identification. Results Excellent agreement was found between PCR and CARBA 5, for all but one isolate. The single false positive result (a blaSME positive S. marcescens isolate) was incorrectly positive for blaOXA-48 by CARBA 5. No cross reactivity was observed. The sensitivity and specificity were 100.0% and 98.0%, respectively. Conclusions The CARBA 5 assay is highly sensitive and specific and is recommended as a tool for the detection of the main carbapenemases of interest in clinical microbiology laboratories.

Evaluation of the NG-Test CARBA 5 Lateral Flow Assay with an IMP-27-Producing Morganella morganii and Other Morganellaceae

“…Hopkins et al reported an NDM-producing isolate that generated a false-positive VIM band, and a dual carbapenemase-producing isolate that generated a false-positive KPC band—though these results were not reproducible ( 15 ). Kon et al reported a SME-producing Serratia marcescens that generated a false-positive OXA-48-like band ( 17 ). These studies did not speculate on the cause of the false-positive bands.…”

“…These studies did not speculate on the cause of the false-positive bands. In the study by Zhu et al the inoculum was described as a 1-μL loopful of bacteria, while in Hopkins et al and Kon et al the inoculum was described as one colony ( 15 , 17 , 20 ). A 1-μL loopful would not constitute an “extra heavy” inoculum; however, since bacterial colonies vary widely in size, it is possible that Hopkins et al or Kon et al overloaded test inoculum in some of their LFAs.…”

The use of high-affinity polyhistidine binders as masking probes for the selection of an NDM-1 specific aptamer

“…Phenotypic assays detect the in vitro enzyme activity of carbapenemases, not necessarily distinguishing between different carbapenemase types. Detection of carbapenemases, which also allows discrimination between different enzyme types and does not require trained technicians, can be accomplished with antibody-based lateral flow devices (LFD) such as the NG-Test® CARBA 5 28 . Antibody-based LFDs are valuable tools for simple and effective point-of-care detection of carbapenemases.…”

Assessment of Urinary Biomarkers for Infectious Diseases Using Lateral Flow Assays: A Comprehensive Overview

“…Additionally, Hadas Kon et al reported a multiplexed LFA study to detect five carbapenemases and to assess the cross reactivity of other OXA-type carbapenemases with OXA-48-like specific antibodies. No cross reactivity was observed, with specificity of 98.0% …”

“…No cross reactivity was observed, with specificity of 98.0%. 82 In another study, proposed by Chun-Wan Yen et al, silver nanoparticles (AgNPs) were conjugated with antibodies of three different infectious, viral pathogens (dengue, ebola, and yellow fever). Multiplexed detection was explored by loading a mixture of orange, red, and green AgNPs with antibodies.…”