Affiliation:
1. Department of Pathology, Division of Medical Microbiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
2. Department of Pediatrics, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Abstract
ABSTRACT
Accurate detection of carbapenemase-producing glucose-nonfermenting Gram-negative bacilli (CPNFs), including
Pseudomonas aeruginosa
and
Acinetobacter baumannii
, is necessary to prevent their dissemination within health care settings. We performed a method comparison study of 11 phenotypic carbapenemase detection assays to evaluate their accuracy for the detection of CPNFs. A total of 96 carbapenem-resistant glucose-nonfermenting isolates were included, of which 29% produced carbapenemases. All CPNFs were molecularly characterized to identify β-lactamase genes. A total of 86% of the carbapenemase-producing
P. aeruginosa
isolates produced class B carbapenemases. Several assays performed with a sensitivity of >90% for the detection of carbapenemase-producing
P. aeruginosa
, including all rapid chromogenic assays and the modified carbapenem inactivation method. Most included assays, with the exception of the Manual Blue Carba assay, the Modified Carba NP assay, the boronic acid synergy test, and the metallo-β-lactamase Etest, had specificities of >90% for detecting carbapenemase-producing
P. aeruginosa
. Class D carbapenemases were the most prevalent carbapenemases among the carbapenemase-producing
A. baumannii
strains, with 60% of the carbapenemase-producing
A. baumannii
isolates producing acquired OXA-type carbapenemases. Although several assays achieved >90% specificity in identifying carbapenemase-producing
A. baumannii
, no assays achieved a sensitivity of greater than 90%. Our findings suggest that the available phenotypic tests generally appear to have excellent sensitivity and specificity for detecting carbapenemase-producing
P. aeruginosa
isolates. However, further modifications to existing assays or novel assays may be necessary to accurately detect carbapenemase-producing
A. baumannii
.
Funder
The Sherrilyn and Ken Fisher Center
HHS | National Institutes of Health
Publisher
American Society for Microbiology
Cited by
38 articles.
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