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Performance Evaluation of Diagnostic Assays for Detection and Classification of Carbapenemase-Producing Organisms

Rapid and accurate detection can help optimize patient treatment and improve infection control against nosocomial carbapenemase-producing organisms (CPO). In this study, a total of 217 routine clinical isolates (Enterobacterales and A. baumannii), including 178 CPOs and 39 non-CPOs, were tested to e...

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Autores principales: Zhang, Anru, Wang, Xiaojuan, Liang, Xinyue, Zhou, Chaoe, Wang, Qi, Zhang, Jiangang, Wang, Hui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8698775/
https://www.ncbi.nlm.nih.gov/pubmed/34943669
http://dx.doi.org/10.3390/antibiotics10121457
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author Zhang, Anru
Wang, Xiaojuan
Liang, Xinyue
Zhou, Chaoe
Wang, Qi
Zhang, Jiangang
Wang, Hui
author_facet Zhang, Anru
Wang, Xiaojuan
Liang, Xinyue
Zhou, Chaoe
Wang, Qi
Zhang, Jiangang
Wang, Hui
author_sort Zhang, Anru
collection PubMed
description Rapid and accurate detection can help optimize patient treatment and improve infection control against nosocomial carbapenemase-producing organisms (CPO). In this study, a total of 217 routine clinical isolates (Enterobacterales and A. baumannii), including 178 CPOs and 39 non-CPOs, were tested to evaluate the performance of six phenotypic carbapenemase detection and classification assays, i.e., BD Phoenix CPO detect panel, Rapidec Carba-NP, O.K.N detection kit, and three carbapenem inactivation methods (CIMs; mCIM, eCIM, sCIM). The overall detection sensitivity and specificity were 98.78% (95.21–99.79%) and 79.49% (63.06–90.13%), respectively, for the BD phoenix CPO P/N test; 91.93% (86.30–95.45%) and 100% (88.83–100%), respectively, for the Rapidec Carba-NP; 98.06% (94.00–99.50%) and 97.44% (84.92–99.87%), respectively, for mCIM; and 96.89% (92.52–98.85%) and 94.87% (81.37–99.11%), respectively, for sCIM. The classification sensitivity and specificity for the BD phoenix CPO Ambler test, the O.K.N detection kit, and the mCIM and eCIM were 56.71% (48.75–64.34%) and 94.87% (81.37–99.11%), 99.28% (95.43–99.96%) and 100% (88.83–100%), and 92.90% (87.35–96.23%) and 97.44% (84.92–99.87%), respectively. All detection assays were reliable in detecting carbapenemase. However, the Rapidec Carba-NP and mCIM were insufficient in detecting OXA-48-like enzymes. The BD phoenix CPO detect panel had a strong ability to detect carbapenemase but failed to classify 48/59 (81.36%) KPC, 8/52 (15.38%) NDM, 8/22 (36.36%) OXA-23-like, and 6/11 (54.55%) dual enzymes. The O.K.N detection kit accurately detected and differentiated KPC, NDM, and OXA-48-like enzymes existing alone or in combination. The results of this study will support reliable laboratory work tools and promote therapeutic and infection control decisions.
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spelling pubmed-86987752021-12-24 Performance Evaluation of Diagnostic Assays for Detection and Classification of Carbapenemase-Producing Organisms Zhang, Anru Wang, Xiaojuan Liang, Xinyue Zhou, Chaoe Wang, Qi Zhang, Jiangang Wang, Hui Antibiotics (Basel) Article Rapid and accurate detection can help optimize patient treatment and improve infection control against nosocomial carbapenemase-producing organisms (CPO). In this study, a total of 217 routine clinical isolates (Enterobacterales and A. baumannii), including 178 CPOs and 39 non-CPOs, were tested to evaluate the performance of six phenotypic carbapenemase detection and classification assays, i.e., BD Phoenix CPO detect panel, Rapidec Carba-NP, O.K.N detection kit, and three carbapenem inactivation methods (CIMs; mCIM, eCIM, sCIM). The overall detection sensitivity and specificity were 98.78% (95.21–99.79%) and 79.49% (63.06–90.13%), respectively, for the BD phoenix CPO P/N test; 91.93% (86.30–95.45%) and 100% (88.83–100%), respectively, for the Rapidec Carba-NP; 98.06% (94.00–99.50%) and 97.44% (84.92–99.87%), respectively, for mCIM; and 96.89% (92.52–98.85%) and 94.87% (81.37–99.11%), respectively, for sCIM. The classification sensitivity and specificity for the BD phoenix CPO Ambler test, the O.K.N detection kit, and the mCIM and eCIM were 56.71% (48.75–64.34%) and 94.87% (81.37–99.11%), 99.28% (95.43–99.96%) and 100% (88.83–100%), and 92.90% (87.35–96.23%) and 97.44% (84.92–99.87%), respectively. All detection assays were reliable in detecting carbapenemase. However, the Rapidec Carba-NP and mCIM were insufficient in detecting OXA-48-like enzymes. The BD phoenix CPO detect panel had a strong ability to detect carbapenemase but failed to classify 48/59 (81.36%) KPC, 8/52 (15.38%) NDM, 8/22 (36.36%) OXA-23-like, and 6/11 (54.55%) dual enzymes. The O.K.N detection kit accurately detected and differentiated KPC, NDM, and OXA-48-like enzymes existing alone or in combination. The results of this study will support reliable laboratory work tools and promote therapeutic and infection control decisions. MDPI 2021-11-26 /pmc/articles/PMC8698775/ /pubmed/34943669 http://dx.doi.org/10.3390/antibiotics10121457 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Zhang, Anru
Wang, Xiaojuan
Liang, Xinyue
Zhou, Chaoe
Wang, Qi
Zhang, Jiangang
Wang, Hui
Performance Evaluation of Diagnostic Assays for Detection and Classification of Carbapenemase-Producing Organisms
title Performance Evaluation of Diagnostic Assays for Detection and Classification of Carbapenemase-Producing Organisms
title_full Performance Evaluation of Diagnostic Assays for Detection and Classification of Carbapenemase-Producing Organisms
title_fullStr Performance Evaluation of Diagnostic Assays for Detection and Classification of Carbapenemase-Producing Organisms
title_full_unstemmed Performance Evaluation of Diagnostic Assays for Detection and Classification of Carbapenemase-Producing Organisms
title_short Performance Evaluation of Diagnostic Assays for Detection and Classification of Carbapenemase-Producing Organisms
title_sort performance evaluation of diagnostic assays for detection and classification of carbapenemase-producing organisms
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8698775/
https://www.ncbi.nlm.nih.gov/pubmed/34943669
http://dx.doi.org/10.3390/antibiotics10121457
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