Rapid Screening for Carbapenem Resistant Organisms: Current Results and Future Approaches

• Main Authors: Shalini Anandan, Sunganya Damodaran, Radha Gopi, Yamuna Devi Bakthavatchalam, Balaji Veeraraghavan
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2015-09-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: carbapenem producing enterobacteriaceae; kpc; ndm; oxa-48; xpert® carba-r; vim
• Online Access: https://jcdr.net/articles/PDF/6530/14246_CE(Ra1)_F(GH)_PF1(VSUAK)_PFA(AK)_PF2(PAG).pdf

Carbapenem producing Enterobacteriaceae (CPE) is a major public health threat. A total of 120 carbapenem resistant E.coli (n=32) and K.pneumoniae (n=88) from blood stream infections were screened for the presence of carbapenem resistant genes KPC, NDM, IMP, VIM, and OXA-48 like using both conventional multiplex PCR and Xpert® Carba-R test. Additionally 26 faeces samples were directly screened with Xpert® Carba-R test. Of the tested isolates, 40% (n=48) of NDM and 39.2% (n=47/) of OXA-48-like were identified. Co-production of OXA-48 and NDM was seen in 15 (12.5%) isolates. In Xpert® Carba-R test, only NDM was identified in 55% (n=66) of tested isolates. Of the tested faeces samples, 12 were identified as carbapenemase producers: nine with NDM, two with the coproduction of NDM and VIM and in Klebsiella spp (n=1), NDM and KPC co-production was seen. However, Xpert® Carba-R test fails to detect OXA-48 like as compared with multiplex PCR. The sensitivity, specificity, PPV, NPV of Xpert® Carba-R test was 100%, 77%, 96% and 100% respectively. Incorporation of OXA-48 like specific sequence in the panel of Xpert® Carba-R test may improve its sensitivity and maximize the coverage of assay.