Carbapenemase Detection and Identification: Which method should be Chosen?

Abstract

Komla Mawunyo Dossouvi, Gnatoulma Katawa and Simplice Damintoti Karou

Carbapenemase production constitutes the key mechanism of resistance to carbapenems. Rapid detection or confirmation of the involvement of carbapenemase-producing bacteria (CPB) in infections is crucial for adequate antibiotic therapy and infection control, particularly during epidemics or for surveillance purposes. The Ambler classification proposes four classes of carbapenemases: classes A, B, C, and D. Carbapenemases A, C, and D are called serine carbapenemases because they use serine in their active site to catalyze the hydrolysis of carbapenems. Class B carbapenemases are metallo-beta-lactamases (MBLs) that use a cation (Zn2+) to hydrolyze the beta-lactam ring. Biochemical, chromogenic, immunochromatographic, mass spectrometric, and molecular methods have both advantages and limitations for carbapenemase detection. Although there is no single method that meets all specifications of an ideal test, it is important to explore methods to identify the most suitable ones. Thus, according to the research articles reported in this review and the criteria (cost, turnaround time, sensitivity, specificity, expertise needs, target carbapenemases), chromogenic tests such as ChromID CARBA SMART and CHROMagarTM mSuperCARBATM would be the best candidates for the rapid and effective detection of carbapenemase-producing bacteria in developing countries. Moreover, Carba NP, SUPERCARBA and Carbapenem Inactivation Method (CIM) could also be considered good carbapenemase-detecting methods. WGS may be reserved for large-scale funded studies of carbapenemase-producing bacteria.

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