Carbapenemases - the complete picture

Rosco's KPC+MBL kit +Temocillin presumptively identifies the three main groups of Carbapenemase that occur in Enterobacteriaceae:

KPC, MBL (NDM,VIM,IMP) & OXA-48

Until recently the unsatisfactory Hodge test was the only simple laboratory test for identification of OXA-48 resistance. Now Rosco offer a reliable easy to use protocol for presumptive carbapenemase identification covering the three groups.

BioConnections KPC + MBL Confirm ID kit is a multi disc method that allows the identification and differentiation of KPC and MBL positive organisms. Carbapenem resistance may also be due to impermeability or the presence of the enzyme OXA-48. The presence of the OXA-48 enzyme can be confirmed through the addition of a temocillin 30µg disc to the ID kit.

The ID kit contains four discs which all contain 10µg meropenem; in addition 3 of the discs also contain inhibitors of various ß-lactamases. By comparing the inhibition zone sizes produced by the suspected organism it is possible to identify the presence of AmpC, MBL and KPC enzymes.

As all OXA-48 producing Enterobacteriaceae are highly resistant to Temocillin they will exhibit no zone of inhibition around the temocillin disc.

HPA guidance issued in 2011 highlights the rapidly increasing numbers of carbapenemase producing Enterobacteriaceae referred to the ARMRL:

The guidance can be downloaded using the following link: HPA guidance on Carbapenemase producers

ARMRL News (Winter 2011-2012, issue 28) reports that there have been outbreaks of hospital infection caused by OXA-48 producers in several European countries recently including the UK. Articles in the newsletter highlight that high-level resistance to temocillin may be a useful indicator of OXA-48 production in enterobacteria that have resistance or reduced susceptibility to carbapenems.

The newsletter can be downloaded using the following link: ARMRL News (Winter 2011-2012, Issue 28)

Rosco KPC + MBL + Temocillin - Interpretation of resistance patterns

Product links:

98006: KPC + MBL Confirm ID

783-12N: Temocillin 30µg

Disc dispensers

98008: ESBL & AmpC Screen ID