Early detection of OXA-48 producing Klebsiella pneumoniae with the use of rapid antibiotic susceptibility testing

Emilie De Muynck; Stien Vandendriessche; Anne-Sophie Messiaen; Kristen Decommer; Diana Huis In 't Veld; Jan J De Waele; Jerina Boelens

doi:10.1007/s10096-024-05007-2

Early detection of OXA-48 producing Klebsiella pneumoniae with the use of rapid antibiotic susceptibility testing

Eur J Clin Microbiol Infect Dis. 2024 Dec 19. doi: 10.1007/s10096-024-05007-2. Online ahead of print.

Authors

Emilie De Muynck¹, Stien Vandendriessche¹, Anne-Sophie Messiaen¹, Kristen Decommer², Diana Huis In 't Veld², Jan J De Waele^{3

4}, Jerina Boelens^{5

6}

Affiliations

¹ Department of Medical Microbiology, Ghent University Hospital, Ghent, Belgium.
² Department of Internal Medicine and Infectious Diseases, Ghent University Hospital, Ghent, Belgium.
³ Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium.
⁴ Department of Internal Medicine and Paediatrics, Ghent University Hospital, Ghent, Belgium.
⁵ Department of Medical Microbiology, Ghent University Hospital, Ghent, Belgium. [email protected].
⁶ Department of Diagnostic Sciences, Ghent University, Ghent, Belgium. [email protected].

PMID: 39699781
DOI: 10.1007/s10096-024-05007-2

Abstract

Rapid antimicrobial susceptibility testing of positive blood cultures can enhance antimicrobial stewardship and patient outcomes. We present a case where OXA-48-producing Klebsiella pneumoniae with low-level carbapenem resistance was suspected 6 h after blood-culture positivity, based on ASTar system (Q-Linea, Sweden) results. OXA-48 carbapenemase presence was confirmed by the OXA-48 K-SeT lateral flow assay (Coris, Belgium) on a short-term subculture. This led to timely therapeutic adjustments. Following this case, we validated the OXA-48 K-SeT and Xpert Carba-R assay (Cepheid, USA) on short-term incubated (6 h) subcultures of positive blood cultures, demonstrating that OXA-48 K-SeT and Xpert Carba-R respectively accurately identified OXA-48 and various (OXA-48, VIM, NDM, KPC, IMP) carbapenemase-producing Enterobacterales (CPE) types. Both assays prove valuable for rapid CPE detection in clinical settings.