Recent advances in the laboratory detection of carbapenemase-producing Enterobacteriaceae

Abstract

Carbapenemase-producing Enterobacteriaceae (CPE), mainly Klebsiella pneumoniae and Escherichia coli, have been increasing rapidly on a global scale and are considered to be significant health threats. The most common carbapenemases are KPCs, NDMs, OXA-48-like, IMPs and VIMs but their distribution and prevalence differs between countries. The accurate, simple, cost effective and rapid detection of carbapenemases in clinical laboratories is an important initial step to control the spread of CPE within institutions. The diversity of carbapenemases in general, has challenged a simple approach for the detection of most types of CPE. This article summarizes the current and describes newer techniques available for the detection of carbapenemases among Enterobacteriaceae. We also provided a simplified approach for the accurate and rapid detection of CPEs that can easily be implemented in a clinical diagnostic laboratory.

Efficiency of BD MAXTM CRE Method on Detection of Carbapenemase-Producing Enterobacteriaceae spp. from Rectal Swab Samples

“…Bu mekanizmalar arasında porin kaybına bağlı dış membran geçirgenliğindeki değişimler ya da efluks sistemleri ile birlikte yüksek oranda AmpC enzimlerinin üretimi sayılabilir. Fakat tüm Gram negatif bakterilerde karbapenem direncinin en önemli nedeni karbapenemaz enzimlerinin üretimidir (1) . KÜE üyelerinde tanımlanan temel karbapenemazlar Ambler Sınıf A, Sınıf B ve Sınıf D içerisinde yer almaktadır.…”

Direct Detection of OXA-48 Carbapenemase Gene in Lysate Samples through Changes in Mechanical Properties of DNA Monolayers upon Hybridization

“…The blaOXA48 gene has been detected in a total analysis time of 1 h 30 min. This is very advantageous since commonly used diagnostic phenotypic methods for the detection of carbapenemase producers require up to 16 -18 h to get the results 18,37 and molecular methods such as conventional PCR may delay more than 4 h. 13,22 Real time PCR allows obtaining immediate results but multiplexed detection is challenging and it is a more costly technique. 23 The methodology presented here based on the dynamic ex-situ measurements of the cantilevers allows to discriminate the digested blaOXA-48 gene in bacterial lysates, being the DNA embedded in excess of bacterial debris, with a rate of true positives and true negatives of 0.73 and 1, respectively.…”

“…Moreover, these tests cannot discriminate types within each class of carbapenemases and they are also unable to confirm in a single test the occurrence of OXA-48 carbapenemase. [12][13][14][15] Thus, a molecular approach to detect OXA-48 producers is required. Molecular diagnostic methods, such as conventional PCR and RT-PCR, are more reliable for carbapenemase identification due to their high sensitivity and specificity.…”

“…26 However, they have not been established yet as alternative techniques to the most used methods. 13 Microcantilevers have proven to be highly sensitive label-free biosensors for microbial DNA detection [27][28][29] and have the potential for developing instruments suitable for both laboratory and point-of-care testing. Here we report the labelfree and PCR-free detection of blaOXA48 gene using total extracted DNA from carbapenem resistant Klebsiella pneumoniae (KP) cultures.…”

Comparison of two commercial carbapenemase gene confirmatory assays in multiresistant Enterobacteriaceae and Acinetobacter baumannii-complex

“…OXA-48-like enzymes). The NDM, OXA-48-like, KPC, IMP and VIM types are the most common global carbapenemases among carbapenemase-producing Enterobacteriacae (CPE) [ 1 , 4 ]. Among A .…”