Fight Antimicrobial Resistance

Carbapenem antibiotics are one of the few remaining antibiotics effective in treating ESBL infections or MDRO. However, carbapenemases, or enzymes produced by bacteria that cause resistance to this class of antibiotics, are also on the rise. NG-Test^® CARBA 5 is a rapid, multiplex, phenotypic lateral flow confirmatory test for the qualitative detection of five common carbapenemases produced by Enterobacterales and Pseudomonas aeruginosa: KPC, OXA-48-like, VIM, IMP, and NDM, that can be used with colonies that screen positive via HardyCHROM^™ CRE.

CARBA 5 is a game-changer in effective patient management, allowing clinicians a clear and rapid understanding of which drugs will benefit patient treatment from those that will not. This allows for better outcomes and more cost-effective care, better control over potential HAI, and aids in the principals of antimicrobial stewardship. Hardy is expanding the diversity of antimicrobial resistance tests to include NG-Test^® MCR-1, to detect the colistin resistance gene mcr-1, and NG-Test^® CTX-M MULTI, to detect CTX-M variants when an ESBL is suspected, though both products are labeled for Research Use Only as of now. NG-Test^® MCR-1 is a rapid immunoassay designed to detect the colistin resistance gene mcr-1 from bacterial colonies.

The MCR (mobilized colistin resistance) gene family— mcr-1, mcr-2, and mcr-3—are an emerging AMR threat. These genes confer plasmid-mediated resistance to colistin (polymyxin E), known as one of the last-line antibiotics for treating patients infected with multi-drug resistant Enterobacterales.  NG-Test^® CTX-M MULTI is to detect CTX-M variants in bacterial colonies when an ESBL is suspected. Currently, more than 170 CTX-M variants have been identified and are presently the most widespread resistance enzymes of clinical significance. All plasmid-mediated types of resistance are easily transferable within hospitals and in the community.

Identifying CTX-M ESBLs early is crucial for preventing spread of resistance genes. Although ESBLs are less common in the U.S. compared to other regions in the world, NG-Test^® CTX-M MULTI is useful in cases where hospitals have a higher CTX-M prevalence within the institution or in the immediate community, as it would provide a more rapid and cost-effective tool compared to molecular detection methods.