Comparison of Different Methods for Detecting Carbapenemase Types in Enterobacterales Species

AIM: This study aims to compare different phenotypic methods for detecting carbapenemases in carbapenem-resistant Enterobacterales BACKGROUND: Carbapenemase-producing Enterobacterales, a major public health threat, require rapid and accurate detection to control their spread and ensure effective pat...

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Main Authors: Cisil Seyma Ozel Davulcu, Alper Akcali
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Journal of Global Antimicrobial Resistance
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213716524002406
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author Cisil Seyma Ozel Davulcu
Alper Akcali
author_facet Cisil Seyma Ozel Davulcu
Alper Akcali
author_sort Cisil Seyma Ozel Davulcu
collection DOAJ
description AIM: This study aims to compare different phenotypic methods for detecting carbapenemases in carbapenem-resistant Enterobacterales BACKGROUND: Carbapenemase-producing Enterobacterales, a major public health threat, require rapid and accurate detection to control their spread and ensure effective patient management. METHODS: A total of 120 Clinical isolates, including 22 carbapenem-sensitive and 98 carbapenem-resistant strains, were inluded. Identification and susceptibility testing were performed using the BD Phoenix M50 system, while carbapenem resistance genes were detected via multiplex PCR (Bioeksen, Turkiye). Phenotypic methods applied included CIM, mCIM, combination disk test (Bioanalyse, Turkiye) and the RESIST-5 rapid test (Coris Bioconcept, Belgium). Sensitivity and specificity were calculated using molecular method as the gold standard. RESULTS: Carbapenem resistance genes were detected in all 98 resistant isolates, with KPC being the most prevalent (71.42%), followed by OXA-48 (21.42%) and NDM (14.2%). Multiple gene positivity was observed in 11.22% of isolates. The CIM test showed 100% sensitivity and specificity at both 6 and 20 hours. The mCIM test had a sensitivity of 90.81% at 6 hours, increasing to 94.89% at 20 hours, with specificities of 72.72% and 86.36%. The combination disc test had a sensitivity of 98.57% for KPC(A), 100% for OXA-48(D) and NDM+OXA-48 (B+D), 50% for OXA-23+OXA-51 (D) and 0% for NDM+KPC (B+A) isolates. The rapid test demonstrated 100% sensitivity. CONCLUSIONS: The rapid test's high sensitivity, simplicity, and full agreement with PCR results suggest its suitability for routine laboratory use. The combination disk test also offers a reliable alternative for detecting carbapenemase production, particularly when considering local resistance patterns.
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spelling doaj-art-0794242236dc47c8874a3d39e11274b02024-12-27T04:08:23ZengElsevierJournal of Global Antimicrobial Resistance2213-71652024-12-013921Comparison of Different Methods for Detecting Carbapenemase Types in Enterobacterales SpeciesCisil Seyma Ozel Davulcu0Alper Akcali1Department of Medical Microbiology, Canakkale Onsekiz Mart University Faculty of Medicine, Canakkale, TurkeyDepartment of Medical Microbiology, Canakkale Onsekiz Mart University Faculty of Medicine, Canakkale, TurkeyAIM: This study aims to compare different phenotypic methods for detecting carbapenemases in carbapenem-resistant Enterobacterales BACKGROUND: Carbapenemase-producing Enterobacterales, a major public health threat, require rapid and accurate detection to control their spread and ensure effective patient management. METHODS: A total of 120 Clinical isolates, including 22 carbapenem-sensitive and 98 carbapenem-resistant strains, were inluded. Identification and susceptibility testing were performed using the BD Phoenix M50 system, while carbapenem resistance genes were detected via multiplex PCR (Bioeksen, Turkiye). Phenotypic methods applied included CIM, mCIM, combination disk test (Bioanalyse, Turkiye) and the RESIST-5 rapid test (Coris Bioconcept, Belgium). Sensitivity and specificity were calculated using molecular method as the gold standard. RESULTS: Carbapenem resistance genes were detected in all 98 resistant isolates, with KPC being the most prevalent (71.42%), followed by OXA-48 (21.42%) and NDM (14.2%). Multiple gene positivity was observed in 11.22% of isolates. The CIM test showed 100% sensitivity and specificity at both 6 and 20 hours. The mCIM test had a sensitivity of 90.81% at 6 hours, increasing to 94.89% at 20 hours, with specificities of 72.72% and 86.36%. The combination disc test had a sensitivity of 98.57% for KPC(A), 100% for OXA-48(D) and NDM+OXA-48 (B+D), 50% for OXA-23+OXA-51 (D) and 0% for NDM+KPC (B+A) isolates. The rapid test demonstrated 100% sensitivity. CONCLUSIONS: The rapid test's high sensitivity, simplicity, and full agreement with PCR results suggest its suitability for routine laboratory use. The combination disk test also offers a reliable alternative for detecting carbapenemase production, particularly when considering local resistance patterns.http://www.sciencedirect.com/science/article/pii/S2213716524002406rapid diagnostic testcarbapenemasecarbapenem resistant Enterobactericeae
spellingShingle Cisil Seyma Ozel Davulcu
Alper Akcali
Comparison of Different Methods for Detecting Carbapenemase Types in Enterobacterales Species
Journal of Global Antimicrobial Resistance
rapid diagnostic test
carbapenemase
carbapenem resistant Enterobactericeae
title Comparison of Different Methods for Detecting Carbapenemase Types in Enterobacterales Species
title_full Comparison of Different Methods for Detecting Carbapenemase Types in Enterobacterales Species
title_fullStr Comparison of Different Methods for Detecting Carbapenemase Types in Enterobacterales Species
title_full_unstemmed Comparison of Different Methods for Detecting Carbapenemase Types in Enterobacterales Species
title_short Comparison of Different Methods for Detecting Carbapenemase Types in Enterobacterales Species
title_sort comparison of different methods for detecting carbapenemase types in enterobacterales species
topic rapid diagnostic test
carbapenemase
carbapenem resistant Enterobactericeae
url http://www.sciencedirect.com/science/article/pii/S2213716524002406
work_keys_str_mv AT cisilseymaozeldavulcu comparisonofdifferentmethodsfordetectingcarbapenemasetypesinenterobacteralesspecies
AT alperakcali comparisonofdifferentmethodsfordetectingcarbapenemasetypesinenterobacteralesspecies