Multiplex lateral flow immunochromatographic assay is an effective method to detect carbapenemases without risk of OXA-48-like cross reactivity

Ann Clin Microbiol Antimicrob. 2021 Sep 4;20(1):61. doi: 10.1186/s12941-021-00469-0.

Abstract

Background: It is essential to detect carriers of carbapenemase-producing Enterobacterales in order to implement infection control measures. The objectives of this study was to evaluate the NG-Test® CARBA 5 (CARBA 5) assay for detection of five carbapenemases and to assess the cross reactivity of other OXA-type carbapenemases with the OXA-48-like specific antibodies.

Methods: A total of 197 Enterobacterales isolates were tested. To evaluate the cross reactivity, 73 carbapenem-resistant A. baumannii, harboring OXA-type variants, were tested. Polymerase chain reaction (PCR) served as gold standard for carbapenemase identification.

Results: Excellent agreement was found between PCR and CARBA 5, for all but one isolate. The single false positive result (a blaSME positive S. marcescens isolate) was incorrectly positive for blaOXA-48 by CARBA 5. No cross reactivity was observed. The sensitivity and specificity were 100.0% and 98.0%, respectively.

Conclusions: The CARBA 5 assay is highly sensitive and specific and is recommended as a tool for the detection of the main carbapenemases of interest in clinical microbiology laboratories.

Keywords: Carbapenem resistant; Carbapenemase; Cross reactivity; Enterobacterales; NG-Test® CARBA 5 assay; OXA-48-like.

MeSH terms

  • Bacterial Proteins / analysis*
  • Bacterial Proteins / genetics
  • Cross Reactions
  • Humans
  • Immunoassay / methods*
  • Sensitivity and Specificity
  • beta-Lactamases / analysis*
  • beta-Lactamases / genetics

Substances

  • Bacterial Proteins
  • beta-Lactamases
  • carbapenemase