RESIST-5 O.O.K.N.V. and NG-Test Carba 5 assays for the rapid detection of carbapenemase-producing Enterobacterales from positive blood cultures: a comparative study

G Bianco; M Boattini; S A V van Asten; M Iannaccone; E Zanotto; T Zaccaria; A T Bernards; R Cavallo; C Costa

doi:10.1016/j.jhin.2020.03.022

RESIST-5 O.O.K.N.V. and NG-Test Carba 5 assays for the rapid detection of carbapenemase-producing Enterobacterales from positive blood cultures: a comparative study

J Hosp Infect. 2020 Jun;105(2):162-166. doi: 10.1016/j.jhin.2020.03.022. Epub 2020 Apr 16.

Authors

G Bianco¹, M Boattini², S A V van Asten³, M Iannaccone², E Zanotto², T Zaccaria², A T Bernards³, R Cavallo², C Costa²

Affiliations

¹ Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy. Electronic address: gabrielebnc87@gmail.com.
² Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy.
³ Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands.

PMID: 32304724
DOI: 10.1016/j.jhin.2020.03.022

Abstract

We prospectively compared the performance of RESIST-5 O.O.K.N.V. and NG-Test Carba 5 assays directly from blood cultures spiked with 130 characterized Enterobacterales isolates. Overall, both assays yielded 100% sensitivity to detect KPC-type carbapenemases and OXA-48-like carbapenemases. Both assays failed to detect KPC-31 and KPC-33, D179Y point mutation variants of KPC-3 and KPC-2, that are deprived of carbapenemase activity and confer resistance to ceftazidime-avibactam. On blood culture bacterial pellets, NDM- and VIM-type carbapenemases were detected in 50.0% and 52.2%, respectively, by RESIST-5 O.O.K.N.V. vs 100% by NG-Test Carba 5. The sensitivity of RESIST-5 O.O.K.N.V. improved to 100% and 95.6%, respectively, by performing the assay on 4-h early subculture.

Keywords: Blood culture; Carbapenemase detection; Ceftazidime-avibactam resistance; D179Y; Enterobacterales; Immunochromatographic assay.

Publication types

Comparative Study

MeSH terms

Anti-Bacterial Agents / pharmacology
Azabicyclo Compounds / pharmacology
Bacterial Proteins
Blood Culture / methods*
Ceftazidime / pharmacology
Drug Combinations
Enterobacteriaceae / drug effects
Enterobacteriaceae / enzymology
Enterobacteriaceae / isolation & purification*
Enterobacteriaceae Infections / blood*
Enterobacteriaceae Infections / diagnosis*
Humans
Immunoassay
Microbial Sensitivity Tests
Prospective Studies
Reagent Kits, Diagnostic
Sensitivity and Specificity
beta-Lactamases

Substances

Anti-Bacterial Agents
Azabicyclo Compounds
Bacterial Proteins
Drug Combinations
Reagent Kits, Diagnostic
avibactam, ceftazidime drug combination
Ceftazidime
beta-Lactamases
carbapenemase