Integrating an LFA Carbapenemase Detection System into the Laboratory Diagnostic Routine: Preliminary Data and Effectiveness Against Enzyme Variants

<b>Background/Objectives</b>. Carbapenemase production is the most diffused carbapenem-resistance mechanism among <i>Enterobacterales</i>, with <i>Klebsiella pneumoniae</i> carbapenemase (KPC), Verona-imipenemase (VIM), New-Delhi metallo-β-lactamase (NDM), imipene...

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Bibliographic Details
Main Authors: Maddalena Calvo, Gaetano Maugeri, Dafne Bongiorno, Giuseppe Migliorisi, Stefania Stefani
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/11/1434
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Summary:<b>Background/Objectives</b>. Carbapenemase production is the most diffused carbapenem-resistance mechanism among <i>Enterobacterales</i>, with <i>Klebsiella pneumoniae</i> carbapenemase (KPC), Verona-imipenemase (VIM), New-Delhi metallo-β-lactamase (NDM), imipenemase (IMP), and oxacillinase (OXA-48) being reported as the main types within Europe. Particularly, Southern Italy holds a concerningly high percentage of carbapenemases-producing <i>Enterobacterales</i> diffused among different hospital settings. These strains may colonize critical patients’ gastrointestinal tracts, often causing disseminations and severe complications. Scientific data recently reported carbapenemase variants’ worldwide diffusion and several double-carbapenemases reports. The diagnostic routine needs devices whose detection rates are extended to similar epidemiological conditions, avoiding a lack of specificity and potential negative results. <b>Methods</b>. We planned a retrospective study including carbapenem- and/or ceftazidime/avibactam-resistant <i>Enterobacterales</i> (62) which were tested with the KPC/IMP/NDM/VIM/OXA-48 Combo Test Kit (KINVO, Medomics Medical Technology, Nanjing, Jiangsu, China) based on the lateral flow assay (LFA) method. <b>Results</b>. We compared its results to the phenotypic antimicrobial susceptibility testing (AST) MIC results, obtaining a 100% agreement rate. The LFA kit reported carbapenemases in all the tested strains, also identifying cases of KPC variants and double-carbapenemases production. <b>Conclusions</b>. Our data demonstrated how LFAs may represent a reliable alternative requiring minimum economic and personnel resources along with simple result interpretations. Future studies will be necessary to further investigate the system effectiveness on a larger isolates’ number and a broad carbapenemase variant spectrum.
ISSN:2075-4418