Rapid Screening for Carbapenem Resistant Organisms: Current Results and
Future Approaches
Published: September 1, 2015 | DOI: https://doi.org/10.7860/JCDR/2015/.6530
Shalini Anandan, Sunganya Damodaran, Radha Gopi, Yamuna Devi Bakthavatchalam, Balaji Veeraraghavan
1. Associate Professor, Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
2. Associate Research Officer, Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
3. Associate Research Officer, Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
4. Associate Research Officer, Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
5. Professor and Head, Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
Correspondence
Dr. Balaji Veeraraghavan,
Professor and Head, Department of Clinical Microbiology, Christian Medical College,
Vellore – 632 004, Tamil Nadu, India.
E-mail: vbalaji@cmcvellore.ac.in
Carbapenem producing Enterobacteriaceae (CPE) is a major public health threat. A total of 120 carbapenem resistant E.coli (n=32) and K.pneumoniae (n=88) from blood stream infections were screened for the presence of carbapenem resistant genes KPC, NDM, IMP, VIM, and OXA-48 like using both conventional multiplex PCR and Xpert® Carba-R test. Additionally 26 faeces samples were directly screened with Xpert® Carba-R test. Of the tested isolates, 40% (n=48) of NDM and 39.2% (n=47/) of OXA-48-like were identified. Co-production of OXA-48 and NDM was seen in 15 (12.5%) isolates. In Xpert® Carba-R test, only NDM was identified in 55% (n=66) of tested isolates. Of the tested faeces samples, 12 were identified as carbapenemase producers: nine with NDM, two with the co-production of NDM and VIM and in Klebsiella spp (n=1), NDM and KPC co-production was seen. However, Xpert® Carba-R test fails to detect OXA-48 like as compared with multiplex PCR. The sensitivity, specificity, PPV, NPV of Xpert® Carba-R test was 100%, 77%, 96% and 100% respectively. Incorporation of OXA-48 like specific sequence in the panel of Xpert® Carba-R test may improve its sensitivity and maximize the coverage of assay.
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