PCR-dipstick DNA Chromatography for detection of Carbapenemase Producing Carbapenem-Resistant Enterobacteriaceae

Fatima Afroz 1, Anwarul Haque 2, *, Qumrul Huda 3, Shaheda Anwar 1, Tetsuya Matsumoto 2 and Ahmed Abu Saleh 1

1 Department of Microbiology and Immunology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka-1000, Bangladesh.
2 Department of Infectious Diseases, International University of Health and Welfare, School of Medicine, 4-3 Kozunomori, Narita City, Japan 286-8686.
3 Department of Anesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka-1000, Bangladesh.
 
Research Article
World Journal of Advanced Research and Reviews, 2023, 18(01), 112–118
Article DOI: 10.30574/wjarr.2023.18.1.0514
 
Publication history: 
Received on 23 February 2023; revised on 01 April 2023; accepted on 03 April 2023
 
Abstract: 
Carbapenemase producing carbapenem-resistant Enterobacteriaceae (CP-CRE) are an epidemiologically important emerging public health threat. Early and reliable detection of CP-CRE is important for containment of these pathogens. The aim of this study was to evaluate and observe the sensitivity of polymerase chain reaction (PCR)-dipstick DNA chromatography (GeneFields CPE) for detection of carbapenemase genes (NDM, OXA-48, KPC, IMP) in comparison to conventional PCR. In this cross-sectional study, a total of 145 carbapenem resistant Enterobacteriaceae isolates were subjected to test for carbapenemase by phenotypic mCIM and genotypic- conventional PCR and PCR-dipstick DNA Chromatography method. In PCR dipstick DNA chromatography assay, after multiplex PCR a DNA-DNA hybridization-based detection system is applied where amplified products can be easily interpreted by observing a blue line in DNA strip visually within 15 minutes without gel electrophoresis. All the CP-CRE isolates (100%) were positive for either NDM or OXA-48 by PCR-dipstick DNA Chromatography assay, whereas 142 (97.9%) isolates were detected by conventional PCR. The positivity rate of NDM, OXA-48 and both NDM and OXA-48 among CP-CRE isolates were 73.8%, 51.7% and 25.5% respectively. The sensitivity, specificity of PCR-dipstick DNA Chromatography assay for detection of NDM and OXA-48 were 100.0%, 92.7% and 98.6%, 97.2% respectively. This assay showed excellent agreement with conventional PCR for detection of CP-CRE. PCR-dipstick DNA chromatography may be an excellent and robust diagnostic tool in terms of rapidity and sensitivity for the detection of CP-CRE.
 
Keywords: 
PCR-dipstick DNA Chromatography; carbapenemase; NDM; OXA-48; Carbapenemase producing carbapenem-resistant Enterobacteriaceae.
 
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