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Products  >  Human-Field  >  RESIST-3 O.K.N.  >  Science

RESIST-3 O.K.N. - Science


• Rapid detection of the main carbapenemases in Brazil directly from spiked blood culture using the RESIST-3 O.K.N. immunoassay.

Wink PL, Martins AS, Inamine E, Dalmolin TV, Barth AL.

Braz J Microbiol. 2019 Jul;50(3):657-662


The emergence of carbapenem-resistant Enterobacterales (CRE) is a matter of public health concern. Carbapenemases are the main mechanism of resistance among CRE, and its rapid detection is essential. The detection of carbapenemases usually requires culture-based methods and molecular assays, which may be costly and need long turnaround times. Recently, an easy and rapid immunochromatographic assay for carbapenemases (OXA-48, KPC, and NDM) detection based in lateral flow immunoassay with specific monoclonal antibodies on a nitrocellulose membrane has been developed. We aimed to evaluate the RESIST-3 O.K.N. in colonies from pure culture as well as in spiked blood cultures with Enterobacterales. All carbapenemase producers (CP) presenting the OXA-48-like, KPC, and NDM enzymes presented positive results in both pure colonies and spiked blood cultures. None of the carbapenemase non-producers (CNP) presented positive results in the tests. A total of 97% CP isolates presented positive results in pure colonies in less than 5 min. For CP directly from blood culture, the mean time to positivity for OXA-48-like and KPC was 1 min, whereas it was 25 min for NDM. Our results indicate that this immunoassay can be used to detect carbapenemases directly from blood culture bottles in a routine diagnostic laboratory, which would reduce the turnaround time of CP detection.



• Rapid detection of NDM, KPC and OXA-48 carbapenemases directly from positive blood cultures using a new multiplex immunochromatographic assay.

Hamprecht A, Vehreschild JJ, Seifert H, Saleh A.

PLoS One. 2018 Sep 14;13(9):e0204157


Bloodstream infections caused by carbapenemase-producing Enterobacteriaceae (CPE) are associated with treatment failure and increased mortality. Detection of CPE from blood cultures (BC) by standard methods takes 16-72 hours, which can delay the initiation of appropriate antimicrobial therapy and compromise patient outcome. In the present study, we developed and evaluated a new method for the rapid detection of carbapenemases directly from positive BC using a new multiplex immunochromatographic test (ICT). The new ICT was assessed using 170 molecularly characterized Enterobacteriaceae clinical isolates including 126 CPE (OXA-48-like (N = 79), KPC (N = 18) and NDM (N = 29)). After spiking with bacteria and incubation in a BC system, blood from positive BC bottles was hemolyzed, bacteria concentrated by centrifugation and lysed. The lysate was transferred to the RESIST-3 O.K.N. ICT (Coris BioConcept, Gembloux, Belgium), which detects OXA-48-like, KPC and NDM carbapenemases. The final results of the ICT were read when they became positive, at the latest after 15 min. All CPE isolates (126/126) were correctly detected with the new protocol (100% sensitivity, 100% specificity). There was perfect concordance between ICT results and molecular characterization. Total time to result was 20-45 min.

CONCLUSIONS: This proof-of-principle study demonstrates that with the newly developed method, OXA-48-like, KPC and NDM carbapenemases can be reliably detected directly from positive BC bottles. The new method is more rapid than other currently available assays and can be performed in any routine microbiology laboratory. This can help to rapidly identify patients with CPE BSI and optimize the management of patients with these difficult-to-treat infections. Further studies are needed to assess the performance of the ICT in routine diagnostics.



• Dépistage du portage des entérobactéries productrices de carbapénémase par le test Resist-3 O.K.N. K-SeT.


38e Réunion interdisciplinaire de chimiothérapie anti-infectieuse 17-18 décembre, 2018 Paris.




• Lateral flow immunochromatographic assay for rapid screening of faecal carriage of carbapenemase-producing Enterobacteriaceae.

Fauconnier C, Dodemont M, Depouhon A, Anantharajah A, Verroken A, Rodriguez-Villalobos H.

J Antimicrob Chemother. 2018 Oct 30

Rapid and effective screening of carbapenemase-producing Enterobacteriaceae (CPE) appears essential for adequate patient management and rapid implementation of infection control measures. Most of these screening techniques require a minimum of 24 h of culture. Molecular assays are an exception since these can be achieved within 1 h, but are expensive and usually require specialized facilities and trained personnel. In this context, lateral immunochromatography performed directly from rectal swab samples could represent a cost-effective alternative with a reduced turnaround time.
Objectives: In this study, we assessed the performance of the OKN K-SeT test (Coris BioConcept, Gembloux, Belgium) for the rapid detection of OXA-48, KPC and NDM CPE directly from rectal swab samples.
Methods: A total of 149 residual rectal swabs, routinely screened for CPE through selective culture and confirmed by PCR, were tested with a defined protocol consisting of a 2.5 h incubation of the swab in an enrichment medium containing meropenem followed by OKN K-SeT testing after centrifugation.
Results:This method displayed an overall sensitivity of 96% and a specificity of 100% with a limit of detection ranging between 104 and 105 cfu/mL.
Conclusions: Whereas this assay appears highly specific, it displays a reduced sensitivity compared with the standard procedure encompassing a culture step. Nonetheless, this rapid method allows an accelerated identification of most CPE carriers at a lower cost and, accordingly, the implementation of early appropriate management procedures.


• Evaluation of two commercial assays for the rapid confirmation of OXA-48 like carbapenemases produced by Klebsiella pneumoniae.

Zarakolu P, Aslan AT, Perry J.

Turk J Med Sci. 2018 Jun 14;48(3):679-680. doi: 10.3906/sag-1804-23


• Current fast methods for the identification of carbapenemase enzymes in clinical laboratory.

D’Aleo F., Ceccarelli M., Facciolà A., Venanzi Rullo E., Paolucci I., Lo Presti Costantino M. R., Fazii P., Conte M., Pellicanò G. F.

Infectious Diseases & Tropical Medicine 2018; 4 (2): e470

Multidrug resistance is growing at an alarming rate among a variety of bacterial species, causing infections, which threaten the lives of patients.

Detection of metal-β-lactamase producers (IMP, VIM, NDM) and of KPC producers may be based on the inhibitory properties of several molecules but requires additional expertise and time.

Several authors describe the use of new rapid identification methods. The aim of our review is to revise the new rapid methods for the detection of carbapenemases and their identification by Gram-negative bacilli.

• E0128 – Carbapenem resistant Enterobacteriaceae (CRE) surveillance can be performed using faecal samples obtained for C.difficile toxin detection without the need for a rectal swab.

M. Wilks, A. Whiley, A. Alcolea-Medina and B.P. Cherian.

28th European Congress of Clinical Microbiology and Infectious Diseases, Infectious Diseases April 21 – 24, 2018.


• P2325 – Rapid detection of carbapenemase-producing organisms directly from blood cultures using a combined MALDI-TOF MS and RESIST O.K.N. workflow.

E. Wey, L. Ainsworth, T. McHugh and I. Balakrishnan.

28th European Congress of Clinical Microbiology and Infectious Diseases, Infectious Diseases April 21 – 24, 2018.


• P2297 – Retrospctive evaluation of Coris BioConcept’s RESIST-3 OKN K-SeT test to detect carbapenemase-producing organisms (CPO) from diverse genetic backgrounds.

B.M. Willey, M. Al-Ani, Y. Sokolskyy, E. Osuji, A. Paterson, DA. Boyd, W. Chui, T. Mazzulli and S.M. Poutanen.

28th European Congress of Clinical Microbiology and Infectious Diseases, Infectious Diseases April 21 – 24, 2018.


• 00812 – Prospective evaluation of Coris BioConcept’s RESIST-3 OKN K-SeT test to detect carbapenemase-producing organisms (CPO) from surveillance cultures.

B.M. Willey, M. Al-Ani, Y. Sokolskyy, E. Osuji, A. Paterson, DA. Boyd, W. Chui, T. Mazzulli and S.M. Poutanen.

28th European Congress of Clinical Microbiology and Infectious Diseases, Infectious Diseases April 21 – 24, 2018.


• E0141 – Trends in resistance mechanisms of carbapenem resistant Klebsiella pneumoniae blood isolates during a two year period in a tertiary care Hellenic hospital.

S. Tsiplakou, V. Papaioannou, E. Koiliari, D. Stefani and M. LelekisA. Saleh, S. Göttig and A. Hamprecht.

28th European Congress of Clinical Microbiology and Infectious Diseases, Infectious Diseases April 21 – 24, 2018.


• 00810 – Rapid detection of carbapenemase-producing Enterobacteriaceae directly from positive blood cultures by a new immunochromatographic assay.

A.Hamprecht, H. Seifert and A. Saleh.

28th European Congress of Clinical Microbiology and Infectious Diseases, Infectious Diseases April 21 – 24, 2018.



• 00193 – Multiplex immunochromatographic detection of OXA-48, KPC and NDM carbapenemases : impact of the inoculum, antibiotics and agar.

A. Saleh, S. Göttig and A. Hamprecht.

28th European Congress of Clinical Microbiology and Infectious Diseases, Infectious Diseases April 21 – 24, 2018.



• Direct detection of carbapenem resistance determinants in clinical specimens using immunochromatographic lateral flow devices.

Wareham DW, Phee LM, Abdul Momin MHF.

J Antimicrob Chemother. 2018 Mar 22. doi: 10.1093.



• Performance of “RESIST-3 O.K.N. K-SeT” immunochromatographic assay for the detection of OXA-48 like, KPC, and NDM carbapenemases in Klebsiella pneumoniae in Turkey.

P. Sağıroğlu, U. Hasdemir, G. Altınkanat Gelmez, B. Aksu, O. Kataruna and G. Söyletir.

Brazilian Journal of Microbiology 49 (2018)885–890   Available online 1 March 2018.

In this study, the performance of the “RESIST-3 O.K.N. K-SeT” (Coris BioConcept, Gembloux, Belgium) immunochromatographic assay was evaluated in 132 Klebsiella pneumoniae comprising 102 carbapenem resistant and 30 carbapenem susceptible isolates. Genotypically known isolates of Gram negative bacteria (n = 22) including various species were also tested by the assay as controls. The isolates tested by the immunochromatographic assay and also were run PCR for blaKPC, blaIMP, blaVIM, blaNDM, and blaOXA-48. The rates of blaNDM, blaOXA-48, and blaKPC in carbapenem resistant isolates were found at 52.9%, 39.2%, and 2.0%, respectively. Both blaNDM and blaOXA-48 were found in six (5.9%) isolates. The results of the assay showed 100% concordance with those obtained by PCR in 132 K. pneumoniae. The agreement between the two methods was found to be identical at the isolate level. The assay also correctly detected all genotypically known isolates of Escherichia coli, Serratia marcescens, Citrobacter freundii, Enterobacter cloacae, K. pneumoniae carrying blaKPC, blaNDM, and/or blaOXA-48. On the other hand, the assay did not exhibit any cross-reaction in control isolates harboring blaIMP and blaVIM. We conclude that the RESIST-3 O.K.N. K-SeT is a reliable, rapid, and user friendly test and we recommend it for routine diagnostic laboratories.


• Multiplex immunochromatographic detection of OXA-48, KPC and NDM carbapenemases: impact of the inoculum, antibiotics and agar.

A. Saleh, S. Göttig and A. Hamprecht.

J Clin Microbiol. 2018 Feb 14. pii: JCM.00050-18.

SYNOPSISFor rapid detection of carbapenemase-producing Enterobacteriaceae (CPE), immunochromatographic lateral flow tests (ICT) have recently been developed. The aim of this study was to assess the new multiplex ICT RESIST-3 O.K.N®. and to investigate if it can be performed directly from susceptibility testing plates. Additionally the impact of the inoculum and carbapenem disks on sensitivity and specificity was evaluated. The new ICT was challenged using 63 CRE isolates, including 51 carbapenemase producers. It was assessed using five different conditions directly from Mueller-Hinton agar (MHA): 1 μl or 10 μl inoculum harvested in the absence of antibiotic pressure or 1 μl taken from the inhibition zone of either ertapenem, imipenem or meropenem disks.The sensitivity of the ICT was 100 % for OXA-48-like and KPC and 94.4 % for NDM with the 1 μl inoculum. When harvested adjacent to a carbapenem disk, the sensitivity increased to 100 %. Additionally, with zinc-supplemented MHA both the sensitivity increased and the NDM band became visible faster (mean time 8 ± 3.9 min for MHA compared to 1.9 ± 1.5 min for MHA+zinc, P=0.0016). The specificity of the ICT was 100%.Conclusions: The RESIST-3 O.K.N. ICT is a sensitive and rapid test for the detection of three highly prevalent carbapenemases. However, false-negative results for NDM can occur. We recommend an inoculum of 1 μl that is harvested adjacent to an ertapenem or meropenem disk and the use of agars with sufficient zinc content to achieve the best performance.


• Improving the detection of carbapenemase-producing organisms (CPO) in a low-prevalence setting: evaluation of four commercial methods and implementation of an algorithm of testing.

G. L. Vanstone, S. Woodhead, K. Roulston, H. Sharma, E. Wey, E. R. Smith, D. Mack and I. Balakrishnan.

Article is presented in J Med Microbiol. 2018 Feb;67(2):208-214.

Carbapenemase-producing organisms (CPOs) can be resistant to almost all β-lactams and represent an increasing threat in healthcare facilities. Detection of these organisms in routine diagnostic laboratories is difficult; here we evaluate four commercially available CPO detection assays and assess their suitability for the clinical laboratory.
A panel of 95 clinical multidrug-resistant organisms (22 NDM, 24 OXA-48, 19 VIM, 4 OXA-23, 3 KPC, 4 NDM+OXA-48, 1 OXA23+NDM, 1 IMI, 1 IMP-1, 9 ESBL, 3 derepressed AmpC and 4 inducible AmpC producers) were tested by the RESIST-3 O.K.N., RapidEC CarbaNP, Acuitas Resistome and Xpert Carba-R assays.Results/Key Findings. The commercial assays performed well, with high sensitivities (96.2-100 %) and specificities (all, 100 %). The RapidEC CarbaNP and Acuitas Resistome were able to detect the broadest range of carbapenemase genotypes. The RESIST-3 O.K.N. and Xpert CarbaR had the shortest turnaround times, whilst the RapidEC CarbaNP was the only assay included in this study that could detect previously undescribed genotypes.
Using an algorithm of the RapidEC CarbaNP, followed by either the RESIST-3 O.K.N. (Enterobacteriaceae) or the Xpert Carba-R (Pseudomonas aeruginosa and Acinetobacter spp.) on suspect CPOs allowed rapid in-house detection and genotyping of a high proportion of CPOs, reducing turnaround time by up to 7 days.



• Amélioration de la détection des Entérobactéries Productrices de Carbapénémase (EPC).

S. Dos Santos, L. Mereghetti, N. Van der Mee-Marquet.

37e Réunion interdisciplinaire de chimiothérapie anti-infectieuse 18-19 décembre, 2017 Paris




• Sorveglianza attiva degli enterobatteri produttori di carbapenemasi in terapia intensiva.

De Rosa P., Abagnale I., Fusco A., Spanò A., Filosa A.

XLVI Congresso Nazionale AMCLI  11-14 Novembre, 2017  Rimini – PALACONGRESSI




• Valutazione del kit RESIST-3O.K.N. K-SeT (Coris Bioconcept-Biolife) per la rilevazione delle carbapenemasi negli enterobatteri.

Meroni E., Mauri C., Viaggi V., Pini B., Principe L., Luzzaro F.

XLVI Congresso Nazionale AMCLI  11-14 Novembre, 2017  Rimini – PALACONGRESSI



• Confronto  tra tecniche per il rilevamento di enterobacteriaceae produttrici di carbapenemasi.

Brossa S., Cipriani R., Zanotto E., Quaranta M.R., Morcinelli M., Zaccaria T., Cavallo R.

XLVI Congresso Nazionale AMCLI  11-14 Novembre, 2017  Rimini – PALACONGRESSI


• OXA-48-, KPC- & NDM-type carbapenemase-producing organism detection.

G L Vanstone, E Wey, R Smith, D Mack and I Balakrishnan.

Article is presented on website of  Pathology in Practice magazine and at the Institute of Biomedical Science congress, 2017 24-27 Sept in Birmingham, UK.

Multidrug resistance exhibited by a range of microorganisms is a growing problem, a prime example being that resulting from carbapenemase production.
Here, Gemma Vanstone and colleagues assess the value of the RESIST-3 O.K.N. lateral-flow immunochromatography assay.


• P4884 – Evaluation of a new multiplex immunochromatographic assay OKN K-SeT for the rapid detection of OXA-48, KPC and NDM carbapenemases from cultured bacteria.

Y. Glupczynski, A. Jousset, S. Evrard, R. Bonnin, TD Huang, L. Dortet, P. Bogaerts and T. Naas.

27th European Congress of Clinical Microbiology and Infectious Diseases, Infectious Diseases April 22 – 25, 2017



• Rapid Detection of Carbapenemases in Enterobacteriaceae: Evaluation of the RESIST-3 O.K.N (OXA-48, KPC, NDM) Multiplexed Lateral Flow Assay.

Wareham DW and Momin MHFA.

J. Clin. Microbiol. Accepted manuscript posted online 1 February 2017 doi:10.1128/JCM.02471-16

The identification, treatment and control of carbapenem resistant Enterobacteriaceae (CRE) infections are a major challenge for healthcare institutions and diagnostic laboratories worldwide.…


• Rapid Detection of OXA-48, KPC and NDM-type carbapenemase producing organisms (CPOs) using the RESIST-3 O.K.N. assay.

G. L. Vanstone, E. Wey, R. Smith, D. Mack, I. Balakrishnan



• Prospective evaluation of the OKN K-SeT assay, a new multiplex immunochromatographic test for the rapid detection of OXA-48-like, KPC and NDM carbapenemases.

Glupczynski Y, Jousset A, Evrard S, Bonnin RA, Huang TD, Dortet L, Bogaerts P, Naas T.

J Antimicrob Chemother. 2017 Mar 22



There is an urgent need for accurate and fast diagnostic tests capable of identifying carbapenemase producers. Here, we assessed the performance of a new multiplex lateral flow assay (OKN K -SeT) for the rapid detection of OXA-48-like, KPC and NDM carbapenemase-producing Enterobacteriaceae from culture colonies.


Two hundred collection isolates with characterized β-lactamase content and 183 non-duplicate consecutive isolates referred to two National Reference Centres over a 2 month period in 2016 were used to evaluate the OKN K -SeT assay.


The assay correctly detected all 42 OXA-48-like-, 27 KPC- and 30 NDM-producing isolates from the collection panel, including 7 isolates that co-produced NDM and OXA-181 carbapenemases. No cross-reactivity was observed with non-targeted carbapenemases ( n  =   41) or with non-carbapenemase producers ( n  =   60). Prospectively, all OXA-48-like ( n  =   69), KPC ( n  =   9) and NDM ( n  =   19) carbapenemase-producing Enterobacteriaceae isolates were correctly detected, while 11 carbapenemase producers not targeted by the assay went undetected [VIM ( n  =   8) and OXA-23/OXA-58-like ( n  =   3)]. Overall, the sensitivity and specificity of the assay were 100%.


The OKN assay is efficient, rapid and easy to implement in the workflow of a clinical microbiology laboratory for the confirmation of OXA-48, NDM and KPC carbapenemases. This test represents a powerful diagnostic tool as it enables the rapid detection of the most clinically important carbapenemases without the need for more costly and less frequently available molecular assays.

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