Carbapenemase Detection in Gram-Negative Enterobacteriaceae
Summary
Carbapenemases are enzymes produced by certain Gram-negative Enterobacteriaceae that hydrolyse carbapenem antibiotics, undermining one of the last lines of defence against multidrug-resistant infections. Rapid and accurate detection of these enzymes is essential for patient management, hospital infection control and surveillance of resistance trends. Detection strategies fall broadly into phenotypic methods, which assess enzymatic activity, and genotypic approaches, which identify resistance genes. Phenotypic assays range from colourimetric tests that monitor antibiotic hydrolysis to simplified inactivation procedures, while molecular techniques include multiplex real-time PCR, loop-mediated isothermal amplification (LAMP) and microarray analyses. Point-of-care immunochromatographic tests provide further options for on-site screening. Implementation of these tools has demonstrated significant impact on outbreak containment, guided antimicrobial stewardship and informed public health policy at a global scale.
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Carbapenemase Detection in Gram-Negative Enterobacteriaceae publication trend
The graph below shows the total number of articles in carbapenemase detection in gram-negative enterobacteriaceae across all publications each year (not limited to Nature Index journals).
Technical terms
Carbapenemase: An enzyme that hydrolyses carbapenem antibiotics, conferring resistance.
Enterobacteriaceae: A large family of Gram-negative bacteria that includes common pathogens such as Escherichia coli and Klebsiella pneumoniae.
Phenotypic assay: A laboratory test that measures the functional activity of carbapenemases, often by detecting antibiotic breakdown.
Genotypic assay: A molecular method that identifies genes encoding carbapenemases, typically using PCR or isothermal amplification.
Loop-mediated isothermal amplification (LAMP): A nucleic acid amplification technique conducted at constant temperature, offering rapid detection without complex thermocycling.
Immunochromatographic test: A point-of-care assay that uses antigen–antibody interactions on a strip to visually indicate the presence of carbapenemase enzymes.
Xpert Carba-R: A cartridge-based, automated real-time PCR platform for rapid identification of major carbapenemase genes directly from clinical samples.
References
- Development of a novel loop-mediated isothermal amplification assay for ß-lactamase gene identification using clinical isolates of Gram-negative bacteria. Frontiers in Cellular and Infection Microbiology (2023).
- Comparison of the NG-Test Carba 5, Colloidal Gold Immunoassay (CGI) Test, and Xpert Carba-R for the Rapid Detection of Carbapenemases in Carbapenemase-Producing Organisms. Antibiotics (2023).
- The impact of enhanced screening for carbapenemase-producing Enterobacterales in an acute care hospital in South Korea. Antimicrobial Resistance & Infection Control (2023).
- Multi-centre evaluation of real-time multiplex PCR for detection of carbapenemase genes OXA-48, VIM, IMP, NDM and KPC. BMC Infectious Diseases (2014).
- The Simplified Carbapenem Inactivation Method (sCIM) for Simple and Accurate Detection of Carbapenemase-Producing Gram-Negative Bacilli. Frontiers in Microbiology (2018).
- Rapid Identification of Carbapenemase Genes in Gram-Negative Bacteria with an Oligonucleotide Microarray-Based Assay. PLOS ONE (2014).
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