Advertisement

Rapid detection of OXA-48-like, KPC, NDM, and VIM carbapenemases in Enterobacterales by a new multiplex immunochromatographic test

  • Christopher Greissl
  • Ahmad Saleh
  • Axel HamprechtEmail author
Original Article

Abstract

The rapid detection of carbapenemase-producing Gram-negative bacteria is indispensable to optimize treatment and avoid the further spread of these organisms. While phenotypic tests are time-consuming and PCR is expensive and not available in many routine laboratories, immunochromatographic tests (ICT) can provide rapid results at moderate cost. The aim of this study was to determine the performance of the new ICT RESIST-4 O.K.N.V. K-SeT (Coris BioConcept, Gembloux, Belgium) which can detect the four most prevalent carbapenemases: OXA-48-like, KPC, NDM, and VIM. Additionally, we analyzed the impact of different culture conditions on the sensitivity. The new ICT was challenged with 169 carbapenem-resistant isolates. Of these, 125 were carbapenemase producers: 43 OXA-48-like, 15 KPC, 29 NDM, and 43 VIM. The ICT correctly detected 129 of the 130 carbapenemases resulting in a sensitivity of 99.2% and specificity of 100% when tested from Mueller-Hinton agar (MHA). The sensitivity of the assay increased to 100% when performed from zinc-supplemented MHA and sheep blood agar (SBA) or when the inoculum was harvested from the inhibition zone of an ertapenem disk. All carbapenemase-negative carbapenem-resistant bacteria tested negative and no cross-reaction was observed. The new ICT is an excellent test for rapid diagnostic of carbapenemase-producing Gram-negatives in the routine laboratory. It is easy to handle and provides rapid results with a high sensitivity. For best results, we recommend to obtain the inoculum from a medium with sufficient zinc or from the inhibition zone of an ertapenem disk.

Keywords

Carbapenemase Immunochromatographic test Enterobacterales Enterobacteriaceae New Delhi metallo-beta-lactamase Verona integron-encoded metallo-beta-lactamase Mueller-Hinton agar 

Notes

Acknowledgements

The RESIST-4 O.K.N.V. K-SeT was supplied free of charge for evaluation by Coris BioConcept. We thank Stephan Göttig from the University Hospital of Frankfurt for providing further carbapenemase-producing isolates.

Funding information

This study was supported by grants from the Faculty of Medicine, University Hospital of Cologne. AH was supported by the German Centre for Infection Research (DZIF).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

For this type of study, formal consent is not required.

Supplementary material

10096_2018_3432_MOESM1_ESM.pptx (131 kb)
ESM 1 (PPTX 131 kb)

References

  1. 1.
    Nordmann P, Naas T, Poirel L (2011) Global spread of carbapenemase-producing Enterobacteriaceae. Emerg Infect Dis 17:1791–1798.  https://doi.org/10.3201/eid1710.110655 CrossRefGoogle Scholar
  2. 2.
    Giske CG, Martinez-Martinez L, Cantón R, Stefani S, Skov R, Glupczynski Y et al (2017) EUCAST guidelines for detection of resistance mechanisms and specific resistances of clinical and/or epidemiological importance, pp 4–12. http://www.eucast.org/resistance_mechanisms. Accessed 15 September 2018
  3. 3.
    Glupczynski Y, Jousset A, Evrard S, Bonnin RA, Huang T-D, Dortet L et al (2017) Prospective evaluation of the OKN K-SeT assay, a new multiplex immunochromatographic test for the rapid detection of OXA-48-like, KPC and NDM carbapenemases. J Antimicrob Chemother 72:1955–1960.  https://doi.org/10.1093/jac/dkx089 CrossRefGoogle Scholar
  4. 4.
    Wareham DW, Abdul Momin MHF (2017) Rapid detection of carbapenemases in Enterobacteriaceae: evaluation of the Resist-3 O.K.N. (OXA-48, KPC, NDM) lateral flow multiplexed assay. J Clin Microbiol 55:1223–1225.  https://doi.org/10.1128/JCM.02471-16 CrossRefGoogle Scholar
  5. 5.
    Saleh A, Göttig S, Hamprecht AG (2018) Multiplex immunochromatographic detection of OXA-48, KPC, and NDM carbapenemases: impact of inoculum, antibiotics, and agar. J Clin Microbiol 56:e00050–e00018CrossRefGoogle Scholar
  6. 6.
    Pfennigwerth N (2017) Report of the German National Reference Centre (NRZ) for nosocomial pathogens. Epidemiol Bull 29:229–33.  https://doi.org/10.17886/EpiBull-2018-034
  7. 7.
    Gruber TM, Gottig S, Mark L, Christ S, Kempf VAJ, Wichelhaus TA et al (2014) Pathogenicity of pan-drug-resistant Serratia marcescens harbouring blaNDM-1. J Antimicrob Chemother.  https://doi.org/10.1093/jac/dku482. 2 [cited 2018 18]; https://academic.oup.com/jac/article-lookup/doi/10.1093/jac/dku482
  8. 8.
    Koroska F, Göttig S, Kaase M, Steinmann J, Gatermann S, Sommer J et al (2017) Comparison of phenotypic tests and an immunochromatographic assay and development of a new algorithm for detection of OXA-48-like carbapenemases. J Clin Microbiol 55:877–883CrossRefGoogle Scholar
  9. 9.
    Gottig S, Hamprecht AG, Christ S, Kempf VAJ, Wichelhaus TA (2013) Detection of NDM-7 in Germany, a new variant of the New Delhi metallo- -lactamase with increased carbapenemase activity. J Antimicrob Chemother 68:1737–1740.  https://doi.org/10.1093/jac/dkt088 CrossRefGoogle Scholar
  10. 10.
    Hamprecht A, Rohde AM, Behnke M, Feihl S, Gastmeier P, Gebhardt F et al (2016) Colonization with third-generation cephalosporin-resistant Enterobacteriaceae on hospital admission: prevalence and risk factors. J Antimicrob Chemother 71:2957–2963.  https://doi.org/10.1093/jac/dkw216 CrossRefGoogle Scholar
  11. 11.
    Jazmati N, Hein R, Hamprecht A (2016) Use of an enrichment broth improves detection of extended-spectrum-Beta-lactamase-producing Enterobacteriaceae in clinical stool samples. J Clin Microbiol 54:467–470.  https://doi.org/10.1128/JCM.02926-15 CrossRefGoogle Scholar
  12. 12.
    Hamprecht A, Vehreschild JJ, Seifert H, Saleh A (2018) Rapid detection of NDM, KPC and OXA-48 carbapenemases directly from positive blood cultures using a new multiplex immunochromatographic assay. PLoS One 13.  https://doi.org/10.1371/journal.pone.0204157
  13. 13.
    Boutal H, Vogel A, Bernabeu S, Devilliers K, Creton E, Cotellon G et al (2018) A multiplex lateral flow immunoassay for the rapid identification of NDM-, KPC-, IMP- and VIM-type and OXA-48-like carbapenemase-producing Enterobacteriaceae. J Antimicrob Chemother 73:909–915.  https://doi.org/10.1093/jac/dkx521 CrossRefGoogle Scholar
  14. 14.
    Kolenda C, Benoit R, Carricajo A, Bonnet R, Dauwalder O, Laurent F (2018) Evaluation of the new multiplex immunochromatographic O.K.N.V K- S et assay for the rapid detection of OXA-48-like, KPC, NDM and VIM carbapenemases. J Clin Microbiol.  https://doi.org/10.1128/JCM.01247-18. 5 [cited 2018 21]; http://jcm.asm.org/lookup/doi/10.1128/JCM.01247-18

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Institute for Medical Microbiology, Immunology and HygieneUniversity Hospital of CologneCologneGermany
  2. 2.DZIF (German Centre for Infection Research), partner site Bonn-CologneCologneGermany

Personalised recommendations