A Focus on Carbapenemase-Producing Pathogens Detection by Phenotypic Tests

Over the past decade the medical community has witnessed the severe compromise of last resort antibiotics such as carbapenems, widely used in the treatment of severe infections, due to multidrug-resistant Enterobacteriaceae. A variety of carbapenem-hydrolyzing enzymes, located on diverse mobile genetic elements, attainable via horizontal transfer, have been associated with the resistant profiles conferred. As the therapeutic pallet diminishes prompt identification forms the cornerstone for effective containment and epidemiological surveillance, in an attempt to hinder dissemination in the hospital and community setting. Nevertheless, issues regarding detection and accurate characterization of the enzyme at hand persist due not only to the variety of proposed methodologies, but also because of the necessity for each laboratory to tailor its workflow to its individual needs and resources. We aim to describe the recent status in phenotypic detection and characterization of carbapenem-hydrolyzing enzymes, with a focus on inhibitor-based tests, which can offer a reliable, cost-effective, easily applicable alternative to other more expensive, in need of specialized personnel and equipment methods.