Evaluation of NG-Test CARBA 5 version 2, Cepheid Xpert Carba-R, and carbapenem inactivation methods in comparison to whole-genome sequencing for the identification of carbapenemases in non-fermenting Gram-negative bacilli
ABSTRACT NG-Test CARBA 5 (NG-Biotech) is a rapid in vitro multiplex immunoassay for the phenotypic detection and differentiation of the “big five” carbapenemase families (KPC, OXA-48-like, VIM, IMP, and NDM). Version 2 of this assay was evaluated alongside the Xpert Carba-R assay (Cepheid, Inc.), th...
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Published in | Journal of clinical microbiology Vol. 61; no. 9; p. e0031623 |
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Main Authors | , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
1752 N St., N.W., Washington, DC
American Society for Microbiology
21.09.2023
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Subjects | |
Online Access | Get full text |
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Summary: | ABSTRACT
NG-Test CARBA 5 (NG-Biotech) is a rapid
in vitro
multiplex immunoassay for the phenotypic detection and differentiation of the “big five” carbapenemase families (KPC, OXA-48-like, VIM, IMP, and NDM). Version 2 of this assay was evaluated alongside the Xpert Carba-R assay (Cepheid, Inc.), the modified carbapenem inactivation method (mCIM), and the CIMTris assay, with a collection of carbapenem-resistant non-fermenting Gram-negative bacilli comprising 138
Pseudomonas aeruginosa
and 97
Acinetobacter baumannii
isolates. Whole-genome sequencing (WGS) was used as the reference standard. For
P. aeruginosa
, NG-Test CARBA 5 produced an overall percentage agreement (OPA) with WGS of 97.1%, compared with 92.8% forXpert Carba-R and 90.6% for mCIM. For
A. baumannii
, as OXA-type carbapenemases (non-OXA-48) are not included, both the NG-Test CARBA 5 and Xpert Carba-R only had an OPA of 6.2%, while the CIMTris performed well with an OPA of 99.0%. The majority of
A. baumannii
isolates (95.9%) tested falsely positive for IMP on NG-Test CARBA 5; no IMP genes were found on WGS. No clear cause was found for this phenomenon; a cross-reacting protein antigen unique to
A. baumannii
is a possible culprit. NG-Test CARBA 5 performed well for carbapenemase detection in
P. aeruginosa
. However, results from
A. baumannii
isolates should be interpreted with caution. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 The authors declare no conflict of interest. |
ISSN: | 0095-1137 1098-660X |
DOI: | 10.1128/jcm.00316-23 |