Evaluation of Diagnostic Performance of RAPIDEC CARBA NP Test for Carbapenemase-Producing Enterobacteriaceae

Wonkeun Song; Gilsung Yoo; Gyu Yul Hwang; Young Uh

doi:10.5145/ACM.2021.19.3.59

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Song, Yoo, Hwang, and Uh: Evaluation of Diagnostic Performance of RAPIDEC CARBA NP Test for Carbapenemase-Producing Enterobacteriaceae

Original Article

Ann Clin Microbiol 2016;19(3):59-64.

Published online: 12 September 2016

DOI: https://doi.org/10.5145/ACM.2021.19.3.59

Evaluation of Diagnostic Performance of RAPIDEC CARBA NP Test for Carbapenemase-Producing Enterobacteriaceae

Wonkeun Song¹, Gilsung Yoo², Gyu Yul Hwang², Young Uh²

^¹Department of Laboratory Medicine, Hallym University College of Medicine, Seoul

^²Department of Laboratory Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea

Correspondence: Young Uh, Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, Korea. (Tel) 82-33-741-1592, (Fax) 82-33-731-0506, (E-mail) u931018@yonsei.ac.kr

Received 10 July 2016 Revised 26 August 2016 Accepted 27 August 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae are resistant to most β-lactam antibiotics except carbapenems. In recent years, infrequently isolated Enterobacteriaceae that produce carbapenemase pose a serious threat in the selection of appropriate therapeutic antibiotics. The rapid detection method of carbapenemase-producing Enterobacteriaceae (CPE) is necessary to prevent the spread of CPE into healthcare facilities.

Methods

One hundred clinical Enterobacteriaceae isolates (Klebsiella pneumoniae 40, Escherichia coli 40, others 20) showing susceptibility to carbapenems and positivity in the CLSI ESBL phenotypic test from November 2015 to March 2016 and 59 stocked Enterobacteriaceae isolates harboring resistance genes producing carbapenemase (K. pneumoniae 56, Enterobacter cloacae 2, E. coli 1; types of CPE: KPC 36, GES 12, NDM 6, VIM 2, OXA 2, IMP 1) were sub-jected to the RAPIDEC CARBA NP test (bioMérieux, France) and CPE phenotypic test using the modified Hodge test (MHT) and carbapenemase inhibition test.

Results

All of the 100 Enterobacteriaceae isolates with carbapenem susceptibility and ESBL positivity were negative on the RAPIDEC CARBA NP test and CPE phenotypic test. Of 59 stock CPE isolates, 53 and 42 showed positive results to the RAPIDEC CARBA NP test and MHT, respectively. The sensitivity and specificity of the RAPIDEC CARBA NP test for detecting CPE were 89.8% and 100%, respectively.

Conclusion

The RAPIDEC CARBA NP test is simple and produces a result within 3 hr. In conclusion, the test is a useful screen for detecting CPE because it shows high sensitivity and specificity for CPE detection.

Keywords: Carbapenem, Carbapenemase, Enterobacteriaceae, Modified Hodge test

References

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Fig. 1.

Phenotype results of KPC-producing K. pneumoniae. (A) Positive finding in RAPIDEC CARBA NP,(B) Positive finding in MHT and CIT. Abbreviations: P, phenylboronic acid disk; M, meropenem disk; E, EDTA disk.

Table 1.

Results of RAPIDEC CARBA NP test result according to reading time

Results by reading time
Type of CPE (No. of tested isolates)	30 min		120 min		Final
	Negative	Positive	Negative	Positive	Negative	Equivocal	Positive
Non-CPE (100)	100	0	100	0	100	0	0
CPE (59)
KPC-2 (15)	0	15	0	15	0	0	15
KPC-3 (21)	0	21	0	21	0	0	21
GES-5 (12)	7	5 (2)	5	7 (2)	5	2*	7
NDM-1 (6)	0	6	0	6	0	0	6
VIM-2 (2)	0	2	0	2	0	0	2
OXA-48 (1)	0	1	0	1	0	0	1
OXA-181 (1)	0	1 (1)	0	1	0	0	1
IMP-1 (1)	1	0	1	0	1	0	1
Total	8	51	6	53	6	2	53

No. in parenthesis means that isolate show weakly positive result.*One isolate changed from weakly positive (30 min) to negative (120 min), one isolate changed from negative to weakly positive. Abbreviation: CPE, carbapenemase-producing Enterobacteriaceae.

Table 2.

Comparison of RAPIDEC CARBA NP test with CPE phenotypic test

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