Ann Lab Med.  2020 May;40(3):259-263. 10.3343/alm.2020.40.3.259.

Rapid Identification of OXA-48-like, KPC, NDM, and VIM Carbapenemase-Producing Enterobacteriaceae From Culture: Evaluation of the RESIST-4 O.K.N.V. Multiplex Lateral Flow Assay

• Song W
• Park MJ
• Jeong S
• Shin DH
• Kim JS
• Kim HS
• Kim HS
• Lee N
• Hong JS
• Jeong SH

• KMID: 2466020
• DOI: http://doi.org/10.3343/alm.2020.40.3.259

Abstract

There is an urgent need for accurate and rapid diagnostic assays capable of identifying carbapenemase-producing Enterobacteriaceae (CPE). We assessed the performance of the RESIST-4 O.K.N.V. (OKNV) assay (Coris BioConcept, Gembloux, Belgium) for the identification of oxacillinase (OXA)-48-like-, Klebsiella pneumoniae carbapenemase (KPC)-, New Delhi metallo-β-lactamase (NDM)-, and Verona integron-encoded metallo-β-lactamase (VIM)-producing Enterobacteriaceae grown on sheep blood agar (SBA) and the CHROMagar KPC medium. Sixty-five carbapenem-resistant Enterobacteriaceae (CRE) isolates with characterized carbapenemase content were used to evaluate the OKNV assay. The assay correctly identified all 30 isolates that produced one of the four targeted carbapenemase families. Additionally, it correctly identified 15 isolates that co-produced KPC and NDM, VIM and NDM or OXA-48-like and NDM, but failed to identify an NDM-1 and OXA-232 co-producing Klebsiella pneumoniae isolate. All 16 non-carbapenemase-producing CRE and four CPE isolates exhibited negative results, and no cross-reaction was observed. Overall, the sensitivity and specificity of the assay were 97.8% and 100%, respectively. The OKNV assay is an accurate and rapid assay for identifying OXA-48-like, KPC, NDM, and VIM carbapenemases produced by Enterobacteriaceae isolates cultured on both SBA and the CHROMagar KPC media in the clinical microbiology laboratory.

Keyword

Carbapenemase-producing Enterobacteriaceae; OXA-48-like; KPC; NDM; VIM; Evaluation; Performance; RESIST-4 O.K.N.V. assay

MeSH Terms

Agar
Enterobacteriaceae*
Humans
Klebsiella pneumoniae
Sensitivity and Specificity
Sheep
Agar

Figure

• 

  Fig. 1 Example of results for a KPC-2 and NDM-1 co-producing Citrobacter freundii isolate grown on (I) sheep blood agar and (II) CHROMagar KPC (1, cassette for (OXA)-48-like (O) and KPC (K); 2, cassette for VIM (V) and NDM (N)). In the case of a negative result, only a single line appears at the position of the control band (C).Abbreviations: OXA, oxacillinase; KPC, Klebsiella pneumoniae carbapenemase; NDM, New Delhi metallo-β-lactamase; VIM, Verona integron-encoded metallo-β-lactamase.

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