{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T13:50:16Z","timestamp":1762005016038,"version":"3.41.2"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,8,20]],"date-time":"2018-08-20T00:00:00Z","timestamp":1534723200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The prevalence of carbapenem\u2010resistant Enterobacteriaceae (<jats:styled-content style=\"fixed-case\">CRE<\/jats:styled-content>) is alarming worldwide causing serious infections. Rapid and accurate identification of <jats:styled-content style=\"fixed-case\">CRE<\/jats:styled-content> is crucial to reduce the mortality and morbidity. In this study, we tried to develop an in\u2010house Carba <jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content> test for detection of <jats:styled-content style=\"fixed-case\">CRE<\/jats:styled-content> and evaluate its performance with others.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective study was conducted with 40 nonrepeating Enterobacteriaceae isolates over a period of 3\u00a0months. All the isolates were screened for carbapenem resistance as per <jats:styled-content style=\"fixed-case\">CLSI<\/jats:styled-content> 2016 guidelines followed by <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content> for bla<jats:styled-content style=\"fixed-case\">NDM<\/jats:styled-content>\u20101, bla<jats:styled-content style=\"fixed-case\">OXA<\/jats:styled-content>\u201048, bla<jats:styled-content style=\"fixed-case\">KPC<\/jats:styled-content>, bla<jats:styled-content style=\"fixed-case\">VIM<\/jats:styled-content>, and bla<jats:styled-content style=\"fixed-case\">IMP<\/jats:styled-content> genes. All the isolates were subjected to five phenotypic tests, that is, in\u2010house Carba <jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">iC<\/jats:styled-content>arba <jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content>), commercial Carba <jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">cC<\/jats:styled-content>arba <jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content>), Blue\u2010Carba, modified Hodge test (<jats:styled-content style=\"fixed-case\">MHT<\/jats:styled-content>), and CHROMagar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 40 isolates, 87.5% were identified as <jats:italic>Escherichia coli<\/jats:italic>, 7.5% were <jats:italic>Klebsiella pneumoniae<\/jats:italic>, 2.5% were <jats:italic>Enterobacter cloacae<\/jats:italic>, and 2.5% were <jats:italic>Citrobacter freundii<\/jats:italic>. Thirty\u2010three of 40 (82.5%) isolates were found to harbor one or more resistant genes. Considering <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content> to be the gold standard test, sensitivity of the phenotypic methods for <jats:styled-content style=\"fixed-case\">CRE<\/jats:styled-content> detection ranged from 63.6% (<jats:styled-content style=\"fixed-case\">MHT<\/jats:styled-content>) to 96.9% (<jats:styled-content style=\"fixed-case\">CHROM<\/jats:styled-content>agar). Both <jats:styled-content style=\"fixed-case\">cC<\/jats:styled-content>arba <jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">iC<\/jats:styled-content>arba <jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content> observed to have highest specificity. The performance of <jats:styled-content style=\"fixed-case\">iC<\/jats:styled-content>arba <jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content> was found comparable with <jats:styled-content style=\"fixed-case\">cC<\/jats:styled-content>arba <jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content> by kappa score 1 and found approximately 10 times less expensive than <jats:styled-content style=\"fixed-case\">cC<\/jats:styled-content>arba NP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">CHROM<\/jats:styled-content>agar was observed most sensitive assay for detection of <jats:styled-content style=\"fixed-case\">CRE<\/jats:styled-content> followed by both Carba <jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content> tests. <jats:styled-content style=\"fixed-case\">iC<\/jats:styled-content>arba <jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content> was proved cheaper and equally good as <jats:styled-content style=\"fixed-case\">cC<\/jats:styled-content>arba <jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content> for detection of CRE.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcla.22652","type":"journal-article","created":{"date-parts":[[2018,8,22]],"date-time":"2018-08-22T15:20:42Z","timestamp":1534951242000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Comparative evaluation of in\u2010house Carba <scp>NP<\/scp> test with other phenotypic tests for rapid detection of carbapenem\u2010resistant Enterobacteriaceae"],"prefix":"10.1002","volume":"33","author":[{"given":"Raunak","family":"Bir","sequence":"first","affiliation":[{"name":"Department of Microbiology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8311-4112","authenticated-orcid":false,"given":"Sarita","family":"Mohapatra","sequence":"additional","affiliation":[{"name":"Department of Microbiology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amarjeet","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Microbiology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonu","family":"Tyagi","sequence":"additional","affiliation":[{"name":"Department of Microbiology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seema","family":"Sood","sequence":"additional","affiliation":[{"name":"Department of Microbiology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bimal Ku","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Microbiology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arti","family":"Kapil","sequence":"additional","affiliation":[{"name":"Department of Microbiology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,8,20]]},"reference":[{"volume-title":"Antibiotic Resistance Threats in the United States, 2013","year":"2013","author":"Centers for Disease Control and Prevention (CDC)","key":"e_1_2_8_2_1"},{"doi-asserted-by":"publisher","key":"e_1_2_8_3_1","DOI":"10.1128\/CMR.00108-14"},{"doi-asserted-by":"publisher","key":"e_1_2_8_4_1","DOI":"10.1111\/1469-0691.12719"},{"doi-asserted-by":"publisher","key":"e_1_2_8_5_1","DOI":"10.1016\/S1473-3099(10)70143-2"},{"doi-asserted-by":"publisher","key":"e_1_2_8_6_1","DOI":"10.1080\/14787210.2016.1206815"},{"volume-title":"Performance Standards for Antimicrobial Susceptibility Testing; 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