Evaluation of the automated BD Phoenix CPO Detect test for detection and classification of carbapenemases in Gram negatives

Abstract

We evaluated the performance of the automated BD Phoenix CPO Detect test (BD-CPO test) for detection and Ambler classification of carbapenemases in Enterobacteriaceae, P.aeruginosa and A.baumannii complex. A collection of 287 Gram-negative clinical isolates, with a reduced susceptibility to at least one carbapenem including 184 carbapenemase-producing organisms (CPO) and 103 non-CPO, was tested. The BD-CPO test showed an overall sensitivity of 89.7% and specificity of 83.5% for carbapenemase detection. 1/7 of class A, 82.9% of class B, and 89.8% of class D carbapenemases were correctly classified. Poor detection sensitivity of 68.9% and specificity of 62.1% in P.aeruginosa was observed. However, combination with ceftazidime/avibactam susceptibility, provided by this panel, increased the performances for P.aeruginosa. The integration of an automated carbapenemase detection and classification in routine susceptibility panels would save time and help for therapeutic management. Further developments are needed to improve the accuracy of the BD-CPO test.

Keywords: Ambler classification; BD CPO detect test; Carbapenemase detection; Carbapenemase producing organism; Gram-negative; Phoenix.