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Abstract
Background
We evaluated the carbapenem inactivation method (CIM) compared with the modified Hodge test (MHT) for the detection of carbapene-mase-producing Gram-negative bacilli.
Methods
A total of 61 isolates of carbapenemase-producing Enterobacteriaceae (CPE: 14 KPC, 7 GES-5, 8 NDM-1, 9 VIM-2, 9 IMP-1, and 14 OXA-48-like), 34 isolates of metallo-β-lactamase (MBL)-producing Pseudomonas spp. (14 VIM-2 and 20 IMP-6), and 70 carbapenem-nonsusceptible carbapenemase-negative isolates were included. The CIM and MHT were performed for all of the isolates. To perform the CIM, a meropenem disk was incubated with a suspension of the isolate to be tested and then on Mueller-Hinton agar with the Escherichia coli ATCC 29522 strains. The absence of an inhibition zone indicates presence of a carbapenemase. The presence of a clearing zone indicates lack of a carbapenemase.
Results
The total sensitivity and specificity of CIM (96% sensitivity and 100% specificity) in carbapenem-nonsusceptible Enterobacteriaceae and Pseudomonas spp. were better than those of the MHT (77% sensitivity and 94% specificity). The interpretation of CIM results was easy, with no or ＜20 mm inhibition zones indicating positivity and ＞20 mm inhibition zones indicating negative carbapenemase activity.
References
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Fig. 1.
Interpretation of carbapenem inactivation method (CIM). The positive results showed the absence of an inhibition zone (A) and the negative results appeared ＞20 mm of inhibition zone diameter (B).
Table 1.
Results of the CIM and MHT in carbapenem-nonsusceptible Enterobacteriaceae isolates
Table 2.
Characteristics of the CIM and MHT in carbapenem-nonsusceptible Pseudomonas spp. isolates
Table 3.
Sensitivity and specificity of the CIM and MHT in carbapenem-nonsusceptible Gram-negative bacilli
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