Evaluation of a new real-time PCR assay (Check-Direct CPE) for rapid detection of KPC, OXA-48, VIM, and NDM carbapenemases using spiked rectal swabs

Diagn Microbiol Infect Dis. 2013 Dec;77(4):316-20. doi: 10.1016/j.diagmicrobio.2013.09.007. Epub 2013 Oct 14.

Abstract

To prevent the spread of carbapenemase-producing bacteria, a fast and accurate detection of patients carrying these bacteria is extremely important. The Check-Direct CPE assay (Check-Points, Wageningen, The Netherlands) is a new multiplex real-time PCR assay, which has been developed to detect and differentiate between the most prevalent carbapenemase genes encountered in Enterobacteriaceae (blaKPC, blaOXA-48, blaVIM, and blaNDM) directly from rectal swabs. Evaluation of this assay using 83 non-duplicate isolates demonstrated 100% sensitivity and specificity and the correct identification of the carbapenemase gene(s) present in all carbapenemase-producing isolates. Moreover, the limit of detection (LoD) of the real-time PCR assay in spiked rectal swabs was determined and showed comparable LoDs with the ChromID CARBA agar. With an excellent performance on clinical isolates and spiked rectal swabs, this assay appeared to be an accurate and rapid method to detect blaKPC, blaOXA-48, blaVIM, and blaNDM genes directly from a rectal screening swab.

Keywords: Antibiotic; Carbapenem resistance; Carriers; Screening.

MeSH terms

  • Bacterial Proteins / genetics*
  • DNA, Bacterial
  • Enterobacteriaceae / classification*
  • Enterobacteriaceae / genetics*
  • Enterobacteriaceae / isolation & purification
  • Enterobacteriaceae Infections / diagnosis*
  • Enterobacteriaceae Infections / microbiology
  • Humans
  • Multiplex Polymerase Chain Reaction
  • Real-Time Polymerase Chain Reaction*
  • Rectum / microbiology
  • Reproducibility of Results
  • Sensitivity and Specificity
  • beta-Lactamases / genetics*

Substances

  • Bacterial Proteins
  • DNA, Bacterial
  • beta-Lactamases
  • carbapenemase