Comparison of three lateral flow immunochromatographic assays for the rapid detection of KPC, NDM, IMP, VIM and OXA-48 carbapenemases in Enterobacterales
Sandrine Bernabeu, Rémy A. Bonnin, Laurent Dortet
Abstract
During the last decade, the emergence and the dissemination of difficult-to-treat bacteria became a major public health issue. Among these difficult-to-treat bacteria, carbapenemase-producing Gram-negatives are often considered the most worrisome. According to the Ambler classification, the most widespread carbapenemases in Enterobacterales belong to Ambler class A (mostly KPC enzymes), MBLs (Ambler class B) of NDM, VIM and IMP type and carbapenem-hydrolysing Ambler class D enzymes of OXA-48 type. During the last 5 years, several new antimicrobial compounds have been marketed for the treatment of difficult-to-treat bacteria, focusing on carbapenemase-producing Enterobacterales (CPE). These new treatments include the association of broad-spectrum β-lactams with new β-lactamase inhibitors (ceftazidime/avibactam, meropenem/vaborbactam, imipenem/relebactam)1,2 and new molecules such as cefiderocol.3 Unfortunately, these new drugs cannot target all CPE. Indeed, the novel β-lactamase inhibitors (avibactam, relebactam and vaborbactam) are not able to inhibit MBLs. Thus, the early detection of CPE as well as the rapid discrimination of the carbapenemase type is a key point to implement hygiene control measures and to quickly adapt the treatment in case of infection. Among available tests, lateral flow immunochromatography assays (LFIAs) offer numerous advantages, including their easiness, their relative low cost and their rapidity (15 min).