ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2025
Evaluation of EUCAST rapid antimicrobial susceptibility testing (RAST) for carbapenemase-producing Klebsiella pneumoniae with focus on KPC variants.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Evaluation of EUCAST Rapid Antimicrobial Susceptibility Testing for Gram-Negative ESKAPEEc Pathogens in Blood Cultures, with a Focus on Carbapenemase-ProducingAntibiotics (Basel, Switzerland) · 2025Article
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6 authors.
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Abstract
purposeTo evaluate the efficacy of the EUCAST Rapid Antimicrobial Susceptibility Testing (RAST) on Klebsiella pneumoniae carrying various carbapenemases, with a focus on KPC variants.
methodsA total of 130 carbapenemase-producing K. pneumoniae (CPKP), encompassing those harboring class A (KPC-2: n = 38; KPC variants: n = 30), class B (n = 42), class D (n = 4) and strains co-producing class A and class B carbapenemases (n = 16), were evaluated for susceptibility to seven antibiotics, including ceftazidime/avibactam (CAZ/AVI), using the EUCAST RAST. Results obtained after 6 h and 8 h of incubation were compared with those obtained by reference broth microdilution. Additionally, the capacity of the RAST method to screen for different types of carbapenemases was assessed.
resultsAll 130 CPKP isolates generated 100% readable zones at both 6 h and 8 h, with overall categorical agreement (CA) rates of > 90% for all tested antibiotics. For isolates producing class A carbapenemases, particularly the KPC variants, the EUCAST RAST showed excellent performance in determining CAZ/AVI susceptibility, achieving 100% CA and no errors at each reading time. However, significant challenges arose for meropenem (MEM), characterized by low CA (73.9%) and high major errors (MEs, 20.1%) at 6 h reading. Extending incubation to 8 h dramatically improved the performance, while the proportion of strains within the ATU remained high (23.3% at 6 h; 30.0% at 8 h).
conclusionsThe EUCAST RAST can be effectively implemented in routine clinical laboratories, particularly in regions like China where K. pneumoniae carrying KPC-2 is widely prevalent. However, caution should be exercised when interpreting the results of MEM for KPC variants.
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