Evaluation of Disk carbapenemase test using improved disks for rapid detection and differentiation of clinical isolates of carbapenemase-producing Enterobacterales

Hyukmin Lee, Jung Lim Kim, Da Hee Jung, Younghee Seo, Myungsook Kim, Dongeun Yong, Kyungwon Lee, Yunsop Chong

Research output: Contribution to journalArticlepeer-review


Objectives: Rapid detection of carbapenemase-producing Enterobacterales (CPE) is important to control spread of the resistance. We previously reported that imipenem disks prepared from injectable imipenem-cilastatin could rapidly detect KPC- and NDM-type carbapenemases. In the present study, we evaluated performance of disks of IPM and combined disks of imipenem-tazobactam and imipenem-EDTA, which were prepared from powders of imipenem and inhibitors. Methods: Isolates of Enterobacterales were recovered from specimens of patients at a tertiary care hospital in Korea during January 2017 and March 2018. Routine CPE detection was performed by the CPE surveillance personnel whereas evaluation of the Disk carbapenemase test (DCT) was performed by the other personnel without knowing the results of surveillance. The DCT was carried out by pressing disks on to colonies and rehydrating in Petri plates and observing color change. Results: The DCT differentiated 688 of 694 (sensitivity 99.1%) carbapenemase-producing isolates in 2.5–20 min: 630 with KPC, 51 with NDM, three with IMP, one with VIM, two with KPC and IMP, and one with NDM and OXA-181. The DCT failed to detect six OXA- 48-like enzyme-producing isolates, but the modified method using 96-well flat-bottom microplates with mineral oil cover detected all 29 OXA-48-like enzyme-producing isolates in 20–120 min. The DCT was negative for all 440 ertapenem-nonsusceptible, carbapenemase gene-negative isolates (specificity 100%). Conclusion: The procedure of DCT is simple and can differentiate isolates of Enterobacterales with KPC-, NDM-, IMP- and VIM-type carbapenemases rapidly, and the modified DCT can detect isolates with OXA-48-like enzymes rapidly.

Original languageEnglish
Pages (from-to)1205-1211
Number of pages7
JournalJournal of Infection and Chemotherapy
Issue number8
Publication statusPublished - 2021 Aug

Bibliographical note

Funding Information:
The authors are grateful to Professor D. M. Livermore, University of East Anglia, the United Kingdom, for providing stock strains with rare carbapenemase genes, with which we were able to perform successful preliminary study (Annals of Laboratory Medicine, 2016; 36:434) and to proceed with this study.

Publisher Copyright:
© 2021 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)


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