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Biology | Immunology and Infectious Disease | Life Sciences
Initially, United States Centre of Disease Control (CDC) recommended culture-based CPE screens; using broth enrichment in tryptone soy broth (TSB), followed by culture onto MacConkey agar with a carbapenem disc. However, this protocol is both time consuming (approx. 48hrs) and labour intensive, making it impractical for routine screening, particularly in a busy hospital laboratory . Some improvements have been observed using commercially available culture plates, particularly in terms of decreased turnaround times (approx. 24hrs) and increased sensitivity/specificity for CPE producers; mSuperCarba (CHROMagar) media, for example has shown an increased sensitivity rate of 83% compared to 69% for MacConkey culture with an imipenem disc . Lateral flow testing has also been utilised as a confirmatory test in several European clinical microbiology laboratories [12, 13]. A recent immunochromatographic development is the NG-Test CARBA 5 (NG Biotech, Guipry, France) which detects the five most prominent Carbapenemases (OXA-48, KPC, NDM, VIM, IMP) in 15 minutes from cultured colonies, at room temperature . A recent study by Keiffer et al,  reported a 100% detection specificity/sensitivity of known Carbapenemase producers in a Swedish reference laboratory. Thus, accurate and timely antibiotic resistant patterns, obtained using either manual or automatic methods, are essential when screening for CPEs. Prompt identification of CPE is essential to implement transmission-based infection prevention and control precautions and limit the potential spread to other patients.
Fahy S, O’Connor JA, O’Brien D, Fitzpatrick L, O’Connor M, Crowley J, Bernard M, Sleator RD, Lucey B, Carbapenemase screening in an Irish tertiary referral hospital: best practice, or can we do better?, Infection Prevention in Practice, https://doi.org/10.1016/ j.infpip.2020.100100. This