Assessing O.K.N.V.I. RESIST‑5 performance for post‑mortem biological samples: A prospective pilot study

Diac,Iuliana; Neculai‑Cândea,Lavinia; Horumbă,Mihaela; Dogăroiu,Cătălin; Costescu,Mihnea; Keresztesi,Arthur-Atilla

doi:10.3892/etm.2023.12302

Assessing O.K.N.V.I. RESIST‑5 performance for post‑mortem biological samples: A prospective pilot study

Authors:
- Iuliana Diac
- Lavinia Neculai‑Cândea
- Mihaela Horumbă
- Cătălin Dogăroiu
- Mihnea Costescu
- Arthur-Atilla Keresztesi
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Affiliations: PhD School, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Legal Medicine and Forensic Pathology, Forensic Clinical County Service Constanța, Faculty of Medicine, ‘Ovidius’ University of Constanța, 900439 Constanța, Romania, Department of Cardiology, County Clinical Emergency Hospital Constanta, 900591 Constanta, Romania, Department of Morphological Sciences, Discipline of Forensic Medicine and Bioethics, Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Clinical Legal Medicine and Forensic Pathology, Mina Minovici National Institute of Legal Medicine, 042122 Bucharest, Romania, Department of Legal Medicine and Forensic Pathology, Covasna County Institution of Forensic Medicine, 520068 Covasna, Romania
Published online on: November 15, 2023 https://doi.org/10.3892/etm.2023.12302
Article Number: 14
Copyright: © Diac et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

In recent years, the emergence of carbapenem‑resistant strains has been increasing worldwide, including in Romania. Rapid tests for post‑mortem examinations have been researched and currently have several applications. In the present study, we aimed to test the performance of O.K.N.V.I. RESIST‑5 tests on impure post‑mortem biological samples compared with a standard of pure cultures. When a death occurs during hospitalization and the issue of malpractice arises, the medico‑legal practice would benefit from rapid tests applicable to post‑mortem samples. Thus, detection and differentiation of the five targeted carbapenemases, namely oxacilinase‑48, Klebsiella pneumoniae carbapenemase, New Delhi metallo‑β‑lactamase, Verona integron‑encoded metallo‑β‑lactamase and imipenemase, could be useful in guiding sampling for third‑party microbiological assessment and could also be an asset from an epidemiological standpoint. The present prospective and observational pilot study included medico‑legal autopsy cases performed at Mina Minovici National Institute of Legal Medicine (Romania) between June and July 2022. A total of two sets of O.K.N.V.I. RESIST‑5 tests were performed: Test I, which was performed on‑site from biological samples obtained during autopsy; and Test II, which was performed on pure cultures after sample inoculation and incubation. Total of 39 O.K.N.V.I. RESIST‑5 rapid tests were performed on 19 biological samples, at least one sample per case. The O.K.N.V.I. RESIST‑5 tests performed on‑site showed an overall sensitivity of 92.3% with a 100% specificity. The results obtained through rapid tests using post‑mortem impure samples were comparable to the results obtained from sample cultures with good sensitivity and specificity. Through post‑mortem screening for carbapenem resistance, it would be possible to narrow down the number of cases that require further bacteriological assessment.

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