Lateral flow immunochromatographic assay for rapid screening of faecal carriage of carbapenemase-producing Enterobacteriaceae

J Antimicrob Chemother. 2019 Feb 1;74(2):357-359. doi: 10.1093/jac/dky429.

Abstract

Background: Rapid and effective screening of carbapenemase-producing Enterobacteriaceae (CPE) appears essential for adequate patient management and rapid implementation of infection control measures. Most of these screening techniques require a minimum of 24 h of culture. Molecular assays are an exception since these can be achieved within 1 h, but are expensive and usually require specialized facilities and trained personnel. In this context, lateral immunochromatography performed directly from rectal swab samples could represent a cost-effective alternative with a reduced turnaround time.

Objectives: In this study, we assessed the performance of the OKN K-SeT test (Coris BioConcept, Gembloux, Belgium) for the rapid detection of OXA-48, KPC and NDM CPE directly from rectal swab samples.

Methods: A total of 149 residual rectal swabs, routinely screened for CPE through selective culture and confirmed by PCR, were tested with a defined protocol consisting of a 2.5 h incubation of the swab in an enrichment medium containing meropenem followed by OKN K-SeT testing after centrifugation.

Results: This method displayed an overall sensitivity of 96% and a specificity of 100% with a limit of detection ranging between 104 and 105 cfu/mL.

Conclusions: Whereas this assay appears highly specific, it displays a reduced sensitivity compared with the standard procedure encompassing a culture step. Nonetheless, this rapid method allows an accelerated identification of most CPE carriers at a lower cost and, accordingly, the implementation of early appropriate management procedures.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacterial Proteins
  • Belgium
  • Carrier State / diagnosis*
  • Carrier State / microbiology
  • Chromatography, Affinity / methods*
  • Enterobacteriaceae / enzymology
  • Enterobacteriaceae / isolation & purification*
  • Enterobacteriaceae Infections / diagnosis
  • Enterobacteriaceae Infections / microbiology
  • Feces / microbiology*
  • Humans
  • Limit of Detection
  • Mass Screening / methods
  • Reagent Kits, Diagnostic
  • Rectum / microbiology
  • Sensitivity and Specificity
  • beta-Lactamases

Substances

  • Bacterial Proteins
  • Reagent Kits, Diagnostic
  • beta-Lactamases
  • carbapenemase