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Rudresh SM, Ravi GS, Sunitha L, et al. Simple, rapid, and cost-effective modified Carba NP test for carbapenemase detection among Gram-negative bacteria. J Lab Physicians. 2017;9(4):303-307doi: 10.4103/JLP.JLP_138_16.
Rudresh, S. M., Ravi, G. S., Sunitha, L., Hajira, S. N., Kalaiarasan, E., & Harish, B. N. (2017). Simple, rapid, and cost-effective modified Carba NP test for carbapenemase detection among Gram-negative bacteria. Journal of laboratory physicians, 9(4), 303-307. https://doi.org/10.4103/JLP.JLP_138_16
Rudresh, Shoorashetty Manohara, et al. "Simple, rapid, and cost-effective modified Carba NP test for carbapenemase detection among Gram-negative bacteria." Journal of laboratory physicians vol. 9,4 (2017): 303-307. doi: https://doi.org/10.4103/JLP.JLP_138_16
Rudresh SM, Ravi GS, Sunitha L, Hajira SN, Kalaiarasan E, Harish BN. Simple, rapid, and cost-effective modified Carba NP test for carbapenemase detection among Gram-negative bacteria. J Lab Physicians. 2017 Oct-Dec;9(4):303-307. doi: 10.4103/JLP.JLP_138_16. PMID: 28966495; PMCID: PMC5607762.
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J Lab Physicians. 2017 Oct-Dec;9(4):303-307. doi: 10.4103/JLP.JLP_138_16.

Simple, rapid, and cost-effective modified Carba NP test for carbapenemase detection among Gram-negative bacteria.

Journal of laboratory physicians

Shoorashetty Manohara Rudresh, Giriyapur Siddappa Ravi, Lakshminarayanappa Sunitha, Sadiya Noor Hajira, Ellappan Kalaiarasan, Belgode Narasimha Harish

Affiliations

  1. Department of Microbiology, ESIC Medical College and PGIMSR, Bengaluru, Karnataka, India.
  2. Department of Microbiology, JIPMER, Puducherry, India.

PMID: 28966495 PMCID: PMC5607762 DOI: 10.4103/JLP.JLP_138_16

Abstract

PURPOSE: Detection of carbapenemases among Gram-negative bacteria (GNB) is important for both clinicians and infection control practitioners. The Clinical and Laboratory Standards Institute recommends Carba NP (CNP) as confirmatory test for carbapenemase production. The reagents required for CNP test are costly and hence the test cannot be performed on a routine basis. The present study evaluates modifications of CNP test for rapid detection of carbapenemases among GNB.

MATERIALS AND METHODS: The GNB were screened for carbapenemase production using CNP, CarbAcineto NP (CANP), and modified CNP (mCNP) test. A multiplex polymerase chain reaction (PCR) was performed on all the carbapenem-resistant bacteria for carbapenemase genes. The results of three phenotypic tests were compared with PCR.

RESULTS: A total of 765 gram negative bacteria were screened for carbapenem resistance. Carbapenem resistance was found in 144 GNB. The metallo-β-lactamases were most common carbapenemases followed by OXA-48-like enzymes. The CANP test was most sensitive (80.6%) for carbapenemases detection. The mCNP test was 62.1% sensitive for detection of carbapenemases. The mCNP, CNP, and CANP tests were equally sensitive (95%) for detection of NDM enzymes among Enterobacteriaceae. The mCNP test had poor sensitivity for detection of OXA-48-like enzymes.

CONCLUSION: The mCNP test was rapid, cost-effective, and easily adoptable on routine basis. The early detection of carbapenemases using mCNP test will help in preventing the spread of multidrug-resistant organisms in the hospital settings.

Keywords: CarbAcineto NP test; Carba NP test; Carbapenemases; carbapenem-resistant organisms; metallo-β-lactamase

Conflict of interest statement

There are no conflicts of interest.

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