Real-Time PCR Kit for Carbapenem Antibiotic Resistance Gene Detection

Carbapenem Antibiotic Resistance Gene

Carbapenem antibiotic resistance represents one of the greatest current challenges for global public health. Carbapenems are broad-spectrum antimicrobials, often used as a last line of treatment for severe infections caused by multi-drug resistant bacteria. The presence of carbapenem resistance genes significantly compromises therapeutic efficacy, increasing morbidity, mortality, and hospital costs.

Genetic Agent

Carbapenem resistance genes encode enzymes called carbapenemases, which are capable of hydrolyzing and inactivating these antibiotics. Among the main genes described are:

KPC (Klebsiella pneumoniae carbapenemase)
NDM (New Delhi metallo-β-lactamase)
OXA-48-like
VIM (Verona integron-encoded metallo-β-lactamase)
IMP (Imipenemase)

These genes are frequently located on plasmids, facilitating horizontal transfer between different bacterial species, such as Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii and Pseudomonas aeruginosa.

Epidemiology

The dissemination of carbapenemase-producing bacteria occurs mainly in hospital environments, especially in intensive care units (ICUs), where there is a higher use of broad-spectrum antibiotics. Transmission can occur through direct contact between patients, via healthcare professionals, or contaminated surfaces.

Genetic mobility associated with plasmids contributes to hospital outbreaks and the rapid spread of resistance at local, national, and international levels.

Clinical Manifestations

Bacteria carrying carbapenem resistance genes can cause serious infections, such as:

Bloodstream infections (bacteremia)
Ventilator-associated pneumonia
Complicated urinary tract infections
Intra-abdominal infections
Surgical site infections

These infections are associated with longer hospital stays, limited therapeutic options, and poorer clinical prognosis.

Diagnosis

Diagnosis of carbapenem resistance is based on a combination of phenotypic tests and molecular methods. Antimicrobial susceptibility testing may indicate reduced susceptibility to carbapenems; however, precise identification of the responsible gene is performed using molecular techniques, such as Real-Time PCR.

Rapid and specific detection of carbapenemase genes is essential for:

Immediate implementation of infection control measures
Appropriate choice of antimicrobial therapy
Epidemiological monitoring
Prevention of hospital outbreaks

Prevention and Control

Controlling the spread of carbapenemase-producing bacteria requires integrated strategies, including:

Active microbiological surveillance
Isolation of colonized or infected patients
Strict hand hygiene
Rational use of antimicrobials (stewardship programs)
Continuous outbreak monitoring

Early detection is one of the central pillars of these strategies.

Health and Economic Importance

Carbapenem resistance is considered a critical priority by the World Health Organization. The health impact includes increased mortality rates, therapeutic limitations, and the risk of community spread.

From an economic perspective, there is a significant increase in hospital costs due to prolonged hospitalizations, the need for high-cost antibiotics, and additional infection control measures.