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CC BY-NC-ND 4.0 · J Lab Physicians 2017; 9(04): 303-307
DOI: 10.4103/JLP.JLP_138_16
Original Article

Simple, rapid, and cost-effective modified Carba NP test for carbapenemase detection among Gram-negative bacteria

Shoorashetty Manohara Rudresh
Department of Microbiology, ESIC Medical College and PGIMSR, Bengaluru, Karnataka, India
,
Giriyapur Siddappa Ravi
Department of Microbiology, ESIC Medical College and PGIMSR, Bengaluru, Karnataka, India
,
Lakshminarayanappa Sunitha
Department of Microbiology, ESIC Medical College and PGIMSR, Bengaluru, Karnataka, India
,
Sadiya Noor Hajira
Department of Microbiology, ESIC Medical College and PGIMSR, Bengaluru, Karnataka, India
,
Ellappan Kalaiarasan
Department of Microbiology, JIPMER, Puducherry, India
,
Belgode Narasimha Harish
Department of Microbiology, JIPMER, Puducherry, India
› Author Affiliations Financial support and sponsorship: Nil.
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Abstract

PURPOSE: Detection of carbapenemases among Gram-negative bacteria (GNB) is important for both clinicians and infection control practitioners. The Clinical and Laboratory Standards Institute recommends Carba NP (CNP) as confirmatory test for carbapenemase production. The reagents required for CNP test are costly and hence the test cannot be performed on a routine basis. The present study evaluates modifications of CNP test for rapid detection of carbapenemases among GNB.

MATERIALS AND METHODS: The GNB were screened for carbapenemase production using CNP, CarbAcineto NP (CANP), and modified CNP (mCNP) test. A multiplex polymerase chain reaction (PCR) was performed on all the carbapenem-resistant bacteria for carbapenemase genes. The results of three phenotypic tests were compared with PCR.

RESULTS: A total of 765 gram negative bacteria were screened for carbapenem resistance. Carbapenem resistance was found in 144 GNB. The metallo-β-lactamases were most common carbapenemases followed by OXA-48-like enzymes. The CANP test was most sensitive (80.6%) for carbapenemases detection. The mCNP test was 62.1% sensitive for detection of carbapenemases. The mCNP, CNP, and CANP tests were equally sensitive (95%) for detection of NDM enzymes among Enterobacteriaceae. The mCNP test had poor sensitivity for detection of OXA-48-like enzymes.

CONCLUSION: The mCNP test was rapid, cost-effective, and easily adoptable on routine basis. The early detection of carbapenemases using mCNP test will help in preventing the spread of multidrug-resistant organisms in the hospital settings.

Key words

Carbapenemases - Carba NP test - CarbAcineto NP test - carbapenem-resistant organisms - metallo-β-lactamase


Publication History

Received: 11 October 2016

Accepted: 14 March 2017

Article published online:
19 February 2020

© 2017.

Thieme Medical and Scientific Publishers Private Ltd.
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