Ann Lab Med 2020; 40(3): 259-263
Rapid Identification of OXA-48-like, KPC, NDM, and VIM Carbapenemase-Producing Enterobacteriaceae From Culture: Evaluation of the RESIST-4 O.K.N.V. Multiplex Lateral Flow Assay
Wonkeun Song, M.D.1, Min-Jeong Park, M.D.1, Seri Jeong, M.D.1, Dong Hoon Shin, M.D.1, Jae-Seok Kim, M.D.1, Hyun Soo Kim, M.D.1, Han-Sung Kim, M.D.1, Nuri Lee, M.D.1, Jun Sung Hong, Ph.D.2, and Seok Hoon Jeong, M.D.2
1Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea; 2Department of Laboratory Medicine and Research Institute of Antimicrobial Resistance, Yonsei University College of Medicine, Seoul, Korea
Corresponding author: Wonkeun Song, M.D.
Department of Laboratory Medicine, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, 1 Singil-ro, Youngdeungpo-gu, Seoul 07441, Korea
Tel: +82-2-829-5259 Fax: +82-2-847-2403 E-mail:
Received: August 27, 2019; Revised: October 14, 2019; Accepted: November 12, 2019; Published online: May 1, 2020.
© Korean Society for Laboratory Medicine. All rights reserved.

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There is an urgent need for accurate and rapid diagnostic assays capable of identifying carbapenemase-producing Enterobacteriaceae (CPE). We assessed the performance of the RESIST-4 O.K.N.V. (OKNV) assay (Coris BioConcept, Gembloux, Belgium) for the identification of oxacillinase (OXA)-48-like-, Klebsiella pneumoniae carbapenemase (KPC)-, New Delhi metallo-β-lactamase (NDM)-, and Verona integron-encoded metallo-β-lactamase (VIM)-producing Enterobacteriaceae grown on sheep blood agar (SBA) and the CHROMagar KPC medium. Sixty-five carbapenem-resistant Enterobacteriaceae (CRE) isolates with characterized carbapenemase content were used to evaluate the OKNV assay. The assay correctly identified all 30 isolates that produced one of the four targeted carbapenemase families. Additionally, it correctly identified 15 isolates that co-produced KPC and NDM, VIM and NDM or OXA-48-like and NDM, but failed to identify an NDM-1 and OXA-232 co-producing Klebsiella pneumoniae isolate. All 16 non-carbapenemase-producing CRE and four CPE isolates exhibited negative results, and no cross-reaction was observed. Overall, the sensitivity and specificity of the assay were 97.8% and 100%, respectively. The OKNV assay is an accurate and rapid assay for identifying OXA-48-like, KPC, NDM, and VIM carbapenemases produced by Enterobacteriaceae isolates cultured on both SBA and the CHROMagar KPC media in the clinical microbiology laboratory.
Keywords: Carbapenemase-producing Enterobacteriaceae, OXA-48-like, KPC, NDM, VIM, Evaluation, Performance, RESIST-4 O.K.N.V. assay

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