EVALUATION OF THE APPLICABILITY OF THE O.K.N.V.I. RESIST-5 AND THE KPC&MBL&0XA-48 DISK TESTS IN A ROUTINE MICROBIOLOGY LABORATORY
DOI:
https://doi.org/10.58395/ffhmsf98Keywords:
Enterobacterales, carbapenemase detection, O.K.N.V.I. RESIST-5, KPC&MBL&0XA-48 disc testsAbstract
Background: The global spread of carbapenemase-producing Enterobacterales (CPE) and the increasing emergence of clinical Enterobacterales harboring multiple carbapenemases of different molecular classes have prioritized the use of rapid molecular detection methods in routine microbiology laboratories. The aim of this study was to evaluate the applicability of the immunochromatographic O. K.N.V.I. RESIST-5 and the KPC&MBL&0XA-48 disc tests in a clinical microbiology laboratory.
Material and methods: The tests were performed with 50 CPE belonging to 8 species and producing 7 molecularly characterized carbapenemases. Six of these isolates carried two different carbapenemases. To assess the specificity of the assays, 18 non-carbapenemase-producing but carbapenem-resistant Enterobacterales (non-CP CRE) were also included. Both tests were performed from a common overnight culture on Mueller-Hinton agar with inoculum harvested around an ertapenem disk.
Results: The O.K.N.V.I. RESIST-5 correctly detected all 56 carbapenemases, including KPC-2 in Klebsiella pneumoniae; OX-48 in Serratia marcescens, Citrobacter freundii, Enterobacter hormaechei and K. pneumoniae; NDM-1 in Escherichia coli, Morganella morganii, E. hormaechei, C. freundii, S. marcescens and K. pneumoniae; VIM-1 in Proteus mirabilis; VIM-4 in C. freundii and S. marcescens; VIM-86 with and without NDM-1 in Providencia stuartii, and NDM-5 with and without OXA-232 in K. pneumoniae. The KPC&MBL&0XA-48 disc tests correctly confirmed KPC, OX-48-like and most MBL except VIM in P. mirabilis. Furthermore, the combination disc tests failed to detect OXA-48-like in pairs with MBL in K. pneumoniae.
Conclusions:The O.K.N.V.I. RESIST-5 multiplex lateral assay is an excellent test for rapid diagnostic of CPE in routine microbiology laboratories. It is easy to handle and provides results with 100% sensitivity and specificity when an inoculum around ertapenem disc from routine antibiogram was used.
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