Detecting carbapenemases: methods, application and regional access. Systematic review
Abstract
Carbapenemases are enzymes that hydrolyze carbapenems and are the main factor causing resistance to these antibiotics worldwide. This systematic review was conducted to describe the sensitivity and specificity of methods for detecting these enzymes, analyzing their applicability in different geographical contexts. The search was conducted in PubMed and Scopus using the PRISMA method. Open-access articles published between 2015 and 2025 were included. After screening, 28 articles were included, whose reliability was assessed using Joanna Briggs Institute tools. The highest sensitivity of 100% was observed in several methods, including real-time multiplex PCR, and the highest specificity of 100% was also reported in multiple molecular and immunochromatographic methods. Significant regional differences were identified in countries with high endemicity and limited resources, where inexpensive phenotypic methods such as Carba NP and Disk Carbapenemase Test predominated. Factors influencing adoption included cost, available infrastructure, health regulations, and the need for rapid diagnosis. The choice of method is appropriate to the available resources, and testing must be implemented according to epidemiological needs to optimize detection and contain dissemination
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