Comparison of Lateral Flow Test and PCR for Carbapenemase Detection in Carbapenem-Resistant Klebsiella pneumoniae and the Ceftazidime-Avibactam Resistance Profile
O Yapıcı, E Dalmanoğlu, AG Şener, TK Atik, AF Anıl, K Demirel, M AysınBackground:
Carbapenem-resistant
Aim:
This study aimed to compare multiplex lateral flow immunochromatographic testing (LFT) and polymerase chain reaction (PCR) for detecting carbapenemase genes in carbapenem-resistant
Methods:
CRKp isolates from patient samples (blood, urine, and respiratory tract) were identified based on colony morphology, Gram stain, and the BD Phoenix M50system. Isolates resistant to ≥1 carbapenem per EUCAST criteria were included. Resistant isolates underwent PCR for
Results:
The distribution patterns of the isolates showed that blaOXA‐48 predominated (n = 27, 38.0% of positive isolates), followed by blaKPC (n = 15, 21.1%) and blaNDM (n = 7, 9.9%). Notably, 22 isolates (31.0%) harbored multiple carbapenemase genes: OXA‐48 + NDM (n = 14, 19.7%), KPC + NDM (n = 4, 5.6%), and OXA‐48 + KPC (n = 4, 5.6%). Neither blaVIM nor blaIMP was detected. The lateral flow test (LFT) demonstrated good agreement with PCR for the detection of blaKPC and blaOXA‐48 genes (Cohen’s κ = 0.72 and 0.65, respectively); however, its accuracy decreased in isolates harboring multiple carbapenemase genes. While susceptibility to ceftazidime– avibactam averaged 28.6% overall among CP‐Kp isolates, it varied according to carbapenemase type, with KPC producers exhibiting the highest rate (46.7%).
Conclusions:
These findings highlight the importance of rapid and easily applicable diagnostic tests, as well as the urgent need for new antimicrobial agents and novel therapeutic approaches (e.g, Phage therapy, immunotherapies).