ISSN: 0973-7510

E-ISSN: 2581-690X

Open Access
John Osei Sekyere , Usha Govinden and Sabiha Yusuf Essack
Antimicrobial Research Unit, School of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa.
J Pure Appl Microbiol. 2016;10(4):2585-2591
https://doi.org/10.22207/JPAM.10.4.14 | © The Author(s). 2016
Received: 28/06/2016 | Accepted: 11/08/2016 | Published: 31/12/2016
Abstract

The efficient detection and distinction of carbapenem-resistant and carbapenemase-producing Enterobacteriaceae continues to pose a major challenge to clinical microbiology laboratories, particularly in resource-constrained countries. Disc diffusion (DD), micro-broth dilution (BMD), Vitek II, Carba NP test, modified Hodge’s test (MHT) and real-time PCR were evaluated on known carbapenem-resistant and carbapenemase-producing clinical Enterobacteriaceae isolates in terms of their sensitivity and specificity using whole genome sequencing (WGS) as the gold standard. DD with meropenem (MRP), real-time PCR, DD with imipenem (IMP), BMD, Carba NP test, and BMD with IMP had sensitivities of 100%, 97.96%, 97.96%, 97.96%, 95.92%, and 95.92% respectively. Real-time PCR and Carba NP test had the highest specificities (100%) and shortest turnaround times (< 3 hours). DD or BMD using meropenem, followed by Carba NP test and PCR were the best protocols for detecting and confirming CPEs clinically. We recommend the Carba NP test and/or DD specifically for resource-constrained laboratories for detection and control of carbapenemase-producing Enterobacteriaceae.

Keywords

Carbapenemase; Carba NP test; modified Hodge’s test; Vitek II; Carbapenem resistance; whole genome sequencing.

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