Evaluation of phenotypic tests for detection of carbapenemases: New modifications with new interpretation |
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Authors: | Gulsen Altinkanat Gelmez Baris Can Ufuk Hasdemir Guner Soyletir |
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Affiliation: | 1. Marmara University School of Medicine, Department of Medical Microbiology, Istanbul, Turkey;2. Marmara University Pendik Training and Research Hospital, Medical Microbiology Laboratory, Istanbul, Turkey;1. Department of Nephrology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan;2. Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan;3. Division of Infection Control and Prevention, University of Fukui Hospital, Fukui, Japan;4. Department of Internal Medicine, National Hospital Organization Awara Hospital, Fukui, Japan;5. Department of Infection Control and Prevention, Kyoto Prefectural University Medicine, Kyoto, Japan;1. Department of Infection Control and Prevention, Osaka City University Hospital, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan;2. Department of Infection Control Science, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan;3. Research Center for Infectious Diseases, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan;4. Bacteriology, Osaka City University Hospital, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan;1. Division of Infectious Diseases and Immunology, Saitama Children''s Medical Center, Saitama, Japan;2. Division of Otorhinolaryngology, Kawagoe Otology Institute, Saitama, Japan;3. Division of Otolaryngology, Saitama Children''s Medical Center, Saitama, Japan;4. Department of Pharmacy, Saitama Children''s Medical Center, Saitama, Japan;5. MicroSKY Lab, Inc., Tokyo, Japan;6. The Medical and Nursing Institution of Akitsu Ryoiku-En for Children/Adults with Severe Motor and Intellectual Disabilities, Tokyo, Japan;1. Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan;2. Trauma and Acute Critical Care Center, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan;3. M & D Data Science Center, Tokyo Medical and Dental University, 2-3-10, Surugadai, Chiyoda-ku, Tokyo, 101-0062, Japan;1. Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China;2. School of Population Health, The University of New South Wales, Sydney, Australia;3. Department of Infectious Diseases, Guangzhou Eighth People''s Hospital, Guangzhou Medical University, Guangzhou, China |
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Abstract: | IntroductionThe emergence and spread of carbapenemase-producing Enterobacterales (CPE) is a worldwide public health threat. Rapid and accurate detection of CPE is essential to prevent their dissemination within health care settings. The aim of this study was to evaluate the performance of CIM, mCIM and mCIM with ammonium bicarbonate (mCIM-A) methods by using different interpretation criteria for detection of carbapenemases.MethodsOne hundred and fifty-three Klebsiella pneumoniae isolates previously characterized by molecular tests, including 133 carbapenemase producers and 20 non-carbapenemase producers, were collected in this study. CIM and mCIM tests were performed as described previously. mCIM-A by adding 50 mM ammonium bicarbonate to the bacterial suspension prepared in tryptic soy broth. The inhibition zone diameter of around meropenem disc was measured and interpreted as positive according to i) Pierce and colleagues (<19 mm), ii) EUCAST meropenem susceptibility breakpoint (<22).ResultsCIM, although seems to be good for carbapenemases other than OXA-48-like and NDM, is not satisfactory (42.3% and 83.4%, respectively) for those enzymes with any of the interpretation criteria. OXA-48-like and NDM were detected with a better performance (88.7% and 92.8, respectively) with mCIM when results were interpreted according to <22 mm zone diameter for OXA-48-like and NDM. The best results were obtained with mCIM-A using <22 mm criteria without any difference in the results of other enzymes and negative strains.Conclusions: mCIM-A method interpreted with <22 mm meropenem zone diameter seems to be preferable compared to CIM and mCIM. mCIM-A is simple and useful tool for identification of CPEs in clinical microbiology laboratories. |
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Keywords: | Carbapenem inactivation method Modified carbapenem inactivation method Ammonium bicarbonate |
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