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- DOI 10.18231/j.ijmr.12638.1934849221
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Xpert carba R assay for carbapenem resistant gram-negative bacterial blood culture isolates: An experience at a tertiary care hospital
Background: Carbapenem resistant blood stream infections are a serious threat to provision of effective and affordable healthcare to the patients. It is important to determine the mechanism of the resistance, so that the appropriate treatment can be provided to the patient. The study aims to evaluate the blood stream infections caused by the carbapenem resistant Gram-negative bacteria which were tested by Xpert Carba R assay.
Materials and Methods: Isolates of Gram-negative bacteria from blood culture of the patients, which had been tested by the Xpert Carba R assay, were included in the study after ethical clearance from the institute ethics committee. The clinical details and the laboratory parameters of the patients were collected from the electronic case records. Statistical analysis was done using SPSS version 23.
Results: Forty-nine isolates were included in the study. The assay was negative for 14.3% (7/49) patients. The common genes detected were blaNDM, 67.3% (33/49) and blaOXA-48, 36.7% (18/49). These genes co-occurred in 20.4% (10/49) patients. The crude mortality rate was the least due to the pathogens with the blaNDM, whilst it was highest for the pathogens with blaNDM + blaOXA-48, though not statistically significant.
Conclusions: The Xpert Carba R assay is useful for the carbapenemase gene detection among the Enterobacterales. The blaNDM gene is the commonest gene detected in the study, blaNDM + blaOXA-48 co-occurrence is common. The Xpert Carba R assay should be used cautiously for the carbapenem resistant Acinetobacter infections, which has higher crude mortality in the study.
References
- Halat DH, Sarkis DK, Moubareck CA. Carbapenem-resistant, Gram-negative bacilli. In: Antibiotic Resistance. Elsevier; 2016. p. 93–119.
- Bush K, Pannell M, Lock JL, Queenan AM, Jorgensen JH, Lee RM, et al. Detection systems for carbapenemase gene identification should include the SME serine carbapenemase. Int J Antimicrob Agents. 2013;41(1):1–4.
- Bai Y, Hao Y, Shao C, Wang Y, Jin Y. Accuracy of Xpert Carba-R assay for the diagnosis of carbapenemase-producing organisms from rectal swabs and clinical isolates. J Mol Diagn. 2021;23(11):1534–44.
- Li HH, He ZJ, Xie LM, Zhang JS, Xie TA, Fan SJ, et al. Evaluation of Xpert Carba-R assay for the detection of carbapenemase genes in gram-negative bacteria. Biomed Res Int. 2021;2021:6614812.
- Bhat PN, Nayak GS, Shetty AK, Prabhu K. Gram negative bacterial blood stream infections with focus on carbapenem resistance: an experience at a South Indian tertiary care hospital. Online J Health Allied Scs. 2024;23(3):5.
- Nayak G, Behera B, Mahapatra A, Tripathy S, Biswal J. Molecular detection of carbapenemase enzymes directly from positive blood cultures using Xpert Carba-R. J Lab Physicians. 2022;14(3):365–8.
- Rajendran S, Gopalakrishnan R, Tarigopula A, Kumar DS, Nambi PS, Sethuraman N, et al. Xpert Carba-R assay on flagged blood culture samples: clinical utility in intensive care unit patients with bacteremia caused by Enterobacteriaceae. Indian J Crit Care Med. 2023;27(9):655–62.
- Kalaivani R, Kali A, Surendran R, Sujaritha T, Ganesh Babu CP. Rapid characterization of carbapenem-resistant Enterobacterales by multiplex lateral flow assay and detection of ceftazidime- avibactam-aztreonam synergy. Indian J Med Microbiol. 2024;47:100530.
- Sheth D, Kothavale S, Gaikwad V, Pardeshi P, Kukreja S, Pujari A. Carbapenemase gene detection using Xpert Carba-R in a tertiary care hospital among extremely drug resistant gram-negative bacilli. Int J Infect Dis. 2022;116:S12–3.
- Giri S, Sen S. Distribution of carbapenemase gene ndm, oxa48, vim and imp in carbapenem resistant Enterobacteriaceae (cre) isolates in a tertiary care hospital in western Maharashtra. Indian J Med Microbiol. 2021;39(4):500–3.
- Solgi H, Nematzadeh S, Giske CG, Badmasti F, Westerlund F, Lin YL, et al. Molecular epidemiology of OXA-48 and NDM-1 producing Enterobacterales species at a university hospital in Tehran, Iran, between 2015 and 2016. Front Microbiol. 2020;11:936.
- Tula MY, Enabulele OI, Ophori EA, Aziegbemhin AS, Iyoha O, Filgona J. A systematic review of the current status of carbapenem resistance in Nigeria: its public health implication for national intervention. Niger Postgrad Med J. 2023;30(1):1–11.
- Rojas-Larios F, Martínez-Guerra BA, López-Jácome LE, Bolado- Martínez E, Vázquez-Larios MDR, Velázquez-Acosta MDC, et al. Active surveillance of antimicrobial resistance and carbapenemase- encoding genes according to sites of care and age groups in Mexico: results from the INVIFAR network. Pathogens. 2023;12(9):1144
- Alnimr A. Carbapenem resistance in Enterobacterales: predicting clinical outcomes in bloodstream infections. Indian J Med Microbiol. 2024;52:100728.
- Cayci YT, Biyik I, Korkmaz F, Birinci A. Investigation of NDM, VIM, KPC and OXA-48 genes, blue-carba and CIM in carbapenem resistant Enterobacterales isolates. J Infect Dev Ctries. 2021;15(5):696–703.
- Satlin MJ, Chen L, Gomez-Simmonds A, Marino J, Weston G, Bhowmick T, et al. Impact of a rapid molecular test for Klebsiella pneumoniae carbapenemase and ceftazidime-avibactam use on outcomes after bacteremia caused by carbapenem-resistant Enterobacterales. Clin Infect Dis. 2022;75(12):2066–75.
- Han R, Shi Q, Wu S, Yin D, Peng M, Dong D, et al. Dissemination of carbapenemases (KPC, NDM, OXA-48, IMP, and VIM) among carbapenem-resistant Enterobacteriaceae isolated from adult and children patients in China. Front Cell Infect Microbiol. 2020;10:314.
- Wu JW, Quyen TLT, Hsieh YC, Chen YY, Wu LT, Pan YJ. Investigation of carbapenem-resistant Klebsiella pneumoniae in Taiwan revealed strains co-harbouring blaNDM and blaOXA-48-like and a novel plasmid co-carrying blaNDM-1 and blaOXA-181. Int J Antimicrob Agents. 2023;62(5):106964. 388 Bhat et al. / Indian Journal of Microbiology Research 2025;12(3):381–388
- Wang TH, Leu YS, Wang NY, Liu CP, Yan TR. Prevalence of different carbapenemase genes among carbapenem-resistant Acinetobacter baumannii blood isolates in Taiwan. Antimicrob Resist Infect Control. 2018;7:123.
- Shi X, Wang H, Wang X, Jing H, Duan R, Qin S, et al. Molecular characterization and antibiotic resistance of Acinetobacter baumannii in cerebrospinal fluid and blood. PLoS One. 2021;16:e0247418.
- Anggraini D, Santosaningsih D, Saharman YR, Endraswari PD, Cahyarini C, Saptawati L, et al. Distribution of carbapenemase genes among carbapenem-non-susceptible Acinetobacter baumanii blood isolates in Indonesia: a multicenter study. Antibiotics (Basel). 2022;11(3):366.
- Traczewski MM, Carretto E, Canton R, Moore NM, Carba-R Study Team. Multicenter evaluation of the Xpert Carba-R assay for detection of carbapenemase genes in gram-negative isolates. J Clin Microbiol. 2018;56(8):e00272–18.
- Grabein B, Arhin FF, Daikos GL, Moore LSP, Balaji V, Baillon-Plot N. Navigating the current treatment landscape of metallo-β- lactamase-producing gram-negative infections: what are the limitations? Infect Dis Ther. 2024;13(11):2423–47.
- Sree RA, Gupta A, Gupta N, Veturi S, Reddy LSK, Begum M, et al. Ceftazidime-avibactam alone or in combination with aztreonam versus polymyxins in the management of carbapenem-resistant Klebsiella pneumoniae nosocomial infections (CAPRI study): a retrospective cohort study from South India. Infection. 2024;52(2):429–37.
- Szymański M, Skiba MM, Piasecka M, Olender A. Synergistic effect of ceftazidime-avibactam with aztreonam on carbapenemase- positive Klebsiella pneumoniae MBL+, NDM. Infect Drug Resist. 2024;17:2307–13.
- Timbrook TT, Olin KE, Spaulding U, Galvin BW, Cox CB. Epidemiology of antimicrobial resistance among blood and respiratory specimens in the United States using genotypic analysis from a cloud-based population surveillance network. Open Forum Infect Dis. 2022;9(7):ofac296.
- Nwafia IN, Ike AC, Orabueze IN, Nwafia WC. Carbapenemase producing Enterobacteriaceae: environmental reservoirs as primary targets for control and prevention strategies. Niger Postgrad Med J. 2022;29(3):183–91. Cite this article: Bhat PN, Prabhu K, Shetty AK, Nayak SG. Xpert carba R assay for carbapenem resistant gram-negative bacterial blood culture isolates: An experience at a tertiary care hospital. Indian J Microbiol Res. 2025;12(3):381–388.
How to Cite This Article
Vancouver
Bhat PN, Prabhu K, Shetty AK, S GN. Xpert carba R assay for carbapenem resistant gram-negative bacterial blood culture isolates: An experience at a tertiary care hospital [Internet]. Indian J Microbiol Res. 2025 [cited 2025 Sep 29];12(3):381-388. Available from: https://doi.org/10.18231/j.ijmr.12638.1934849221
APA
Bhat, P. N., Prabhu, K., Shetty, A. K., S, G. N. (2025). Xpert carba R assay for carbapenem resistant gram-negative bacterial blood culture isolates: An experience at a tertiary care hospital. Indian J Microbiol Res, 12(3), 381-388. https://doi.org/10.18231/j.ijmr.12638.1934849221
MLA
Bhat, Prasanna N, Prabhu, Kavitha, Shetty, Anup Kumar, S, Ganesh Nayak. "Xpert carba R assay for carbapenem resistant gram-negative bacterial blood culture isolates: An experience at a tertiary care hospital." Indian J Microbiol Res, vol. 12, no. 3, 2025, pp. 381-388. https://doi.org/10.18231/j.ijmr.12638.1934849221
Chicago
Bhat, P. N., Prabhu, K., Shetty, A. K., S, G. N.. "Xpert carba R assay for carbapenem resistant gram-negative bacterial blood culture isolates: An experience at a tertiary care hospital." Indian J Microbiol Res 12, no. 3 (2025): 381-388. https://doi.org/10.18231/j.ijmr.12638.1934849221