Advances in carbapenemase detection in Gram-negtive bacilli

Abstract

With increasing use of carbapenem antibiotics, carbapenems-resistant gram-negative bacteria are spreading, and carbapenemase-producing is the main mechanism of carbapenems resistance. Rapid and accurate identification of carbapenemase and its type is of great importance to timely and effective treatment and control of infections. Chromogenic/Fluorogenic culture media, modified Hodge test and double disk synergy test are traditional methods for carbapenemase detection, but all are time-consuming. Biochemical method is more time efficient and with high sensitivity and specificity, but cannot be used to identify subtypes. Now matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) has been successfully applied in the identification of species, subtypes and detection of drug-resistant genes. And among various carbapenemase gene detection techniques, next generation sequencing (NGS) can also be used for the detection of integrons, transposons and plasmids, which is important in both epidemiology and resistant mechanism studies. This article reviews the advantages and disadvantages of various methods for phenotype and gene detection of carbapenemase. Key words: Gram-negative bacteria; Carbapenemase; Drug resistance; Phenotype; Genotype