OXA-23 Carbapenemase Detection: A Key to Antimicrobial Resistance Prevention and Control

Clinical Background

Carbapenem antibiotics serve as a critical line of defense against multidrug-resistant Gram-negative bacterial infections in clinical settings. However, the diminishing efficacy of these antibiotics has become a major global public health challenge. Among the various carbapenemase types, OXA-23 carbapenemase mediates resistance to carbapenems and is particularly prevalent in Acinetobacter baumannii. Rapid and accurate detection of OXA-23 carbapenemase is of great significance for clinical diagnosis and treatment, infection prevention and control, and antimicrobial resistance surveillance. It also represents a key step in curbing the spread of resistant bacteria.

Resistance Mechanism of OXA-23 Carbapenemase

OXA-23 carbapenemase belongs to Ambler class D βlactamases and is one of the major class D enzymes mediating carbapenem resistance. Its encoding gene can be horizontally transferred among different bacteria via mobile genetic elements such as transposons and plasmids, leading to rapid dissemination of resistant phenotypes. OXA-23 is the predominant resistance mechanism in carbapenemresistant Acinetobacter baumannii (CRAB) worldwide.

Clinical Significance of OXA23 Detection: Facilitating Precision Diagnosis and Prevention

Guiding Clinical Therapy and Reducing InfectionRelated Mortality

Carbapenem antibiotics are important agents for treating multidrugresistant A. baumannii infections. However, strains carrying OXA23 hydrolyze the βlactam ring of carbapenems, rendering these drugs ineffective. Blind use of carbapenems not only fails to control the infection but may also delay appropriate treatment, increase patient financial burden, and raise mortality rates. Studies have shown that the 90day mortality rate for patients infected with carbapenemresistant A. baumannii exceeds 60%. Rapid detection of OXA23 carbapenemase can clarify the resistance mechanism and provide guidance for clinical drug selection.

-Positive result indicates carbapenems are likely ineffective; clinicians should promptly adjust the regimen to alternative agents such as sulbactamcontaining combinations, polymyxins, or tigecycline.

-Negative result allows prioritization of carbapenems, improving the likelihood of treatment success.

Interrupting Transmission and Preventing Nosocomial Outbreaks

The gene encoding OXA23 is highly transmissible. As a major nosocomial pathogen, A. baumannii can easily spread within hospital environments. Rapid and accurate detection of OXA23 enables timely identification of infected patients and carriers, facilitating infection control measures including isolation, environmental disinfection, and hand hygiene reinforcement. This helps cut off transmission pathways and prevent hospital outbreaks.

Detection Solution for OXA23 Carbapenemase

The Macro & Micro-Test OXA23 Carbapenemase Detection Kit (Colloidal Gold Method) has obtained NMPA medical device registration and is also CE certified. It is intended for the qualitative in vitro detection of OXA23 carbapenemase produced by bacteria from human specimens after culture.

-Fast and efficient: Results are available within 15 minutes;

-High performance: Excellent sensitivity helps avoid false negatives and ensures detection accuracy.

-Userfriendly operation: Individually packaged, readytouse, and disposable, suitable for rapid clinical testing scenarios.

-Long shelf life: Product is stable for up to two years, simplifying inventory management.

-Strong clinical value: Assists in rapid and accurate screening of OXA23, providing a critical reference for appropriate antibiotic selection and precision antiinfective therapy.

Conclusion

The widespread prevalence and transmission of OXA23 carbapenemase have seriously undermined the clinical efficacy of carbapenem antibiotics and intensified the challenges of multidrugresistant infection prevention and control. Detection of this enzyme is not only a prerequisite for rational antibiotic use but also a critical step in blocking the spread of resistant bacteria, conducting antimicrobial resistance surveillance, and advancing prevention strategies. It plays an essential role in reducing infectionrelated mortality, conserving healthcare resources, and safeguarding public health.

References

[1] Zhang H, Xu XH. Carbapenemase and epidemic distribution of Acinetobacter baumannii. Chinese Journal of Antibiotics. 2020;45(9):855-860.

[2] Ding L, Chen BY, Li M, et al. Expert consensus on combined antimicrobial susceptibility testing and reporting for carbapenemresistant Gramnegative bacilli. Chinese Journal of Infection and Chemotherapy. 2023;23(1):80-90.

[3] Chen BY, He LX, Hu BJ, et al. Chinese expert consensus on diagnosis, treatment and prevention of Acinetobacter baumannii infection. National Medical Journal of China. 2012;92(2):76-85.

[4] Cohen R, Lipman-Arens S, Ben-Natan O, et al. Mortality impact of carbapenemresistant Acinetobacter baumannii (CRAB) colonization and infection: a retrospective cohort study. Infection Control & Hospital Epidemiology. 2025;46:1206-1214. DOI:10.1017/ice.2025.10315

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