Evaluation of the MBT STAR-Carba Assay for the Detection of Carbapenemase Production in Enterobacteriaceae and Hafniaceae with a Large Collection of Routine Isolates from Plate Cultures and Patient-Derived Positive Blood Cultures

Microb Drug Resist. 2020 Nov;26(11):1298-1306. doi: 10.1089/mdr.2019.0466. Epub 2020 May 15.

Abstract

The spread of carbapenemase-producing Enterobacterales is a major public health concern worldwide, and methods for their prompt and reliable detection are highly demanded for therapeutic and hygiene control purposes. In this study, we evaluate the MBT STAR®-Carba assay (Bruker Daltonik) to detect the carbapenemase production in clinical and surveillance isolates from plate cultures and directly from patient-derived positive blood cultures bottles. Overall, n = 1,307 samples were analyzed (n = 900 plate cultures, and n = 407 positive blood cultures, using the bacterial pellet obtained with the Sepsityper® Kit; Bruker Daltonik), including n = 793 carbapenemase producers (n = 579 Klebsiella pneumoniae carbapenemase, n = 161 metallo-beta-lactamases, n = 45 OXA-48, and eight isolates harboring two different enzymes), n = 239 carbapenem-resistant noncarbapenemase producers, and n = 275 carbapenem-susceptible strains. The STAR-Carba assay detected 657/661 (99.4%) carbapenemase producers from plate cultures, and 132/132 (100%) from positive blood cultures. Specificity resulted in 100% for carbapenem-susceptible strains, and 91.6% for carbapenem-resistant strains resulted negative for carbapenamase production with the routine methods used in this study. In this study, the MBT STAR-Carba assay proved to be a highly reliable method for the detection of carbapenemase-producing Enterobacterales, regardless of the enzyme family, and from both plate cultures and positive blood culture bottles.

Keywords: MALDI-TOF MS; carbapenemase detection; carbapenemase-producing Enterobacterales; hydrolysis assay.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Bacterial Proteins / metabolism*
  • Biological Assay / methods*
  • Blood Culture / instrumentation
  • Carbapenem-Resistant Enterobacteriaceae / metabolism*
  • Carbapenems / pharmacology
  • Enterobacteriaceae / metabolism*
  • Enterobacteriaceae Infections / drug therapy
  • Enterobacteriaceae Infections / microbiology*
  • Humans
  • Microbial Sensitivity Tests / methods
  • Sensitivity and Specificity
  • beta-Lactamases / metabolism*

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Carbapenems
  • beta-Lactamases
  • carbapenemase