Evaluation of the RAPIDEC®CARBA NP, the Rapid CARB Screen®and the Carba NP test for biochemical detection of carbapenemase-producing Enterobacteriaceae

Abstract

Objectives The objective of this study was the evaluation of the performance of two commercially available biochemical tests for the rapid detection of carbapenemase-producing Enterobacteriaceae compared with a home-made technique. Methods A collection of 150 enterobacterial isolates, including 132 isolates with decreased susceptibility to at least one carbapenem molecule, were tested for carbapenemase activity using the RAPIDEC^® CARBA NP (bioMérieux), the Rapid CARB Screen^® (Rosco Diagnostica) and the home-made Carba NP test. This strain collection included 55 non-carbapenemase producers, 21 KPC producers, 21 NDM producers, 17 VIM producers, 11 IMP producers, 16 OXA-48 producers and 9 OXA-48-like producers (OXA-162, OXA-181, OXA-204, OXA-232 and OXA-244). Results The RAPIDEC^® CARBA NP detected all carbapenemase producers except a single OXA-244 producer. Using the Rapid CARB Screen^®, one KPC-2, two NDM-1, one OXA-48 and five OXA-48 variant producers gave equivocal results and one OXA-244 producer was not detected. Using the Carba NP test, the same OXA-244 producer was not detected and one OXA-181 producer and one OXA-244 producer gave equivocal results. Sensitivity and specificity were 99% (95% CI 94.3%–99.8%) and 100% (95% CI 93.5%–100%), respectively, for the RAPIDEC^® CARBA NP test, 89.5% (95% CI 81.7%–94.2%) and 70.9% (95% CI 57.9%–81.2%) for the Rapid CARB Screen^® and 96.8% (95% CI 91.1%–98.9%) and 100% (95% CI 93.5%–100%) for the Carba NP test. The impact of the use of an adequate bacterial inoculum for obtaining the optimal performance with the RAPIDEC^® CARBA NP was noted. Conclusions The RAPIDEC^® CARBA NP possesses the best performance for rapid and efficient detection of carbapenemase-producing Enterobacteriaceae.