Title: Carba NP Test as a Rapid Diagnostic Tool for Carbapenemase Producers
Authors: Dalia H Abd El Hamid, Sherin Ahmed EL-Masry, Amira Mohamed Mokhtar, Eman Mohamed Kamel
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.131
Abstract
The increasing resistance to carbapenems is a worldwide clinical concern. Resistance is mainly due to carbapenemases, which hydrolyse most β-lactams. Carbapenemases are found on diverse mobile genetic elements that may carry multiple resistance genes, leading to resistance to many antibiotic classes. Because of the complexity and diversity of carbapenem resistance mechanisms, particularly carbapenemase- mediated resistance, rapid and accurate detection is necessary to inform appropriate therapy. Carba NP and CarbAcineto NP tests are biochemical tests with relatively high sensitivities and specificities and faster turnaround times than culture based methods. The aim of this work is to detect the ability of Carba NP test to rapidly identify carbapenemase producing isolates. During this study, 100 carbapenem-resistant gram-negative isolates were subjected to Carba NP or CarbAcineto NP tests, subcultured on CHROMagar KPC media and tested by PCR for blaKPC, blaVIM, blaOXA, blaGES, blaIMP.94/100 (94%) isolates were positive for carbapenemase production by both Carba NP and CarbAcineto NP tests. 100/100 (100%) were positive by CHRM agar KPC. 94/100 (94%) isolates were positive for carbapenemase production by PCR. Carba NP test showed a sensitivity, specificity, PPV and NPV of 100% compared to PCR in Enterobacteriaceae and Pseudomonas spp. CarbAcineto NP test showed a sensitivity, specificity, PPV and NPV of 100% compared to PCR in Acinetobacterspp. CHRO Magar KPC test showed a sensitivity, specificity and PPV of 100%, 0%, and 94% respectively compared to PCR. In conclusion, Carba NP and CarbAcineto NP tests are highly sensitive and specific, cheap, rapid tests for the detection of carbapenemase production.
Keywords: Carba NP test, KPC, CHROMagar KPC, CarbAcineto NP, Carbapenem.
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