In this study, we evaluated the performance of the two commercial methods (Rapidec Carba NP and NG-Test Carba-5) for the rapid detection of carbapenemase-producing Klebsiella pneumoniae. A total of 224 Klebsiella pneumoniae strains previously characterized for carbapenemase genes by polymerase chain reaction were included in the study. The strain collection included 30 non-carbapenemase producers, 85 OXA-48-like, 59 NDM, 14 IMP, 7 KPC, 7 VIM, 19 OXA-48-like plus NDM, and 3 KPC plus NDM producers. Rapidec Carba NP and NG-Test Carba 5 was performed according to the manufacturer's instructions. NG-Test Carba 5 correctly detected all carbapenemase-producing K. pneumoniae, however, Rapidec Carba NP failed to detect 41% of OXA-48-like producers even with extended incubation time. The overall sensitivity and specificity were 81,9% and 100% for Rapidec Carba NP, 100% and 100% for NG-Test Carba 5, respectively. Both tests seem to be fast and reliable for the detection of carbapenemase-producing K. pneumoniae especially for microbiology laboratories where molecular tests cannot be performed. However, Rapidec Carba NP with weak hydrolysis activity for OXA-48 like might be used in regions where OXA-48 is not prevalent. The additional advantage of NG-Test Carba 5 is that it specifically detects carbapenemases giving way to threat-related infections with an effective drug such as ceftazidime-avibactam or meropenem- vaborbactam.

在本研究中，我们评估了两种商业方法（Rapidec Carba NP 和 NG-Test Carba-5）快速检测产碳青霉烯酶肺炎克雷伯菌的性能。该研究共纳入了 224 株肺炎克雷伯菌菌株，之前通过聚合酶链反应鉴定了碳青霉烯酶基因。菌株集合包括 30 个非碳青霉烯酶生产者、85 个 OXA-48 样、59 个 NDM、14 个 IMP、7 个 KPC、7 个 VIM、19 个 OXA-48 样加 NDM 和 3 个 KPC 加 NDM 生产者。 Rapidec Carba NP 和 NG-Test Carba 5 是根据制造商的说明进行的。 NG-Test Carba 5 正确检测到所有产生碳青霉烯酶的肺炎克雷伯菌，然而，即使延长孵育时间，Rapidec Carba NP 也未能检测到 41% 的 OXA-48 样产生者。 Rapidec Carba NP 的总体敏感性和特异性分别为 81.9% 和 100%，NG-Test Carba 5 的总体敏感性和特异性分别为 100% 和 100%。这两种测试对于检测产生碳青霉烯酶的肺炎克雷伯菌来说似乎都是快速可靠的，特别是对于无法进行分子测试的微生物实验室而言。然而，对 OXA-48 等具有弱水解活性的 Rapidec Carba NP 可能会在 OXA-48 不普遍的地区使用。 NG-Test Carba 5 的另一个优点是，它可以使用头孢他啶-阿维巴坦或美罗培南-伐硼巴坦等有效药物专门检测碳青霉烯酶，从而导致与威胁相关的感染。