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. 2014 Jul;6(2):69-75.
doi: 10.4103/0974-2727.141497.

Detection of Carbapenemase Production in Gram-negative Bacteria

Sonal Asthana  1 , Purva Mathur  1 , Vibhor Tak  1
Affiliations

Detection of Carbapenemase Production in Gram-negative Bacteria

Sonal Asthana et al. J Lab Physicians. 2014 Jul.

Abstract

The greatest threat to antimicrobial treatment of infections caused by Gram-negative bacteria is the production of carbapenemases. Metallo-beta-lactamases and plasmid-mediated serine carbepenemases like Klebsiella pneumonia carbapenemase are threatening the utility of almost all currently available beta-lactams including carbapenems. Detection of organisms producing carbapenemases can be difficult, because their presence does not always produce a resistant phenotype on conventional disc diffusion or automated susceptibility testing methods. These enzymes are often associated with laboratory reports of false susceptibility to carbapenems which can be potentially fatal. Moreover, most laboratories do not attempt to detect carbapenemases. This may be due to the lack of availability of guidelines and procedures or lack of knowledge and expertise. Because routine susceptibility tests may be unreliable, special tests are required to detect the resistance mechanisms involved. This document describes the standard methodology for detection of various types of carbapenemases, which can be put to use by laboratories working on antimicrobial resistance in Gram-negative bacteria.

Keywords: Carbapenemases; Gram-negative bacteria; Klebsiella pneumoniae carbapenemase; New Delhi metallo-beta-lactamase; metallo-beta-lactamases.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
E-test showing carbapenemase production
Figure 2
Figure 2
Modified Hodge test
Figure 3
Figure 3
Phantom zone in E-test indicating carbapenemase production
Figure 4
Figure 4
Different methods of detection of metallo-beta-lactamase and Klebsiella pneumoniae carbapenemases
See this image and copyright information in PMC

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