Evaluation of the modified carbapenem inactivation method for the detection of carbapenemase-producing Enterobacteriaceae

Kuchibiro, Tomokazu; Komatsu, Masaru; Yamasaki, Katsutoshi; Nakamura, Tatsuya; Nishio, Hisaaki; Nishi, Isao; Kimura, Keigo; Niki, Makoto; Ono, Tamotsu; Sueyoshi, Noriyuki; Kita, Machiko; Kida, Kaneyuki; Ohama, Masanobu; Satoh, Kaori; Toda, Hirofumi; Mizutani, Tetsu; Fukuda, Nozomi; Sawa, Kana; Nakai, Isako; Kofuku, Tomomi; Orita, Tamaki; Watari, Hideo; Shimura, Satoshi; Fukuda, Saori; Nakamura, Akihiro; Wada, Yasunao

doi:10.1016/j.jiac.2017.11.010

Cited by 30 publications

(23 citation statements)

References 18 publications

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“…In the present study, mCIM demonstrated to be an excellent phenotypic test for carbapenemase detection (Table 1). Our findings corroborate the results of previous studies that have reported nearly 100% sensitivity and specificity of mCIM for detecting commonly found carbapenemase types such as KPC, NDM, VIM, IMP, and OXA-48-like [18,30,31]. mCIM is suitable for a resource-poor microbiology laboratory as it is inexpensive and easy to perform.…”

Section: Discussionsupporting

confidence: 90%

Comparison of four low-cost carbapenemase detection tests and a proposal of an algorithm for early detection of carbapenemase-producing Enterobacteriaceae in resource-limited settings

2021

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Rapidly progressing antibiotic resistance is a great challenge in therapy. In particular, the infections caused by carbapenem-resistant Enterobacteriaceae (CRE) are exceedingly difficult to treat. Carbapenemase production is the predominant mechanism of resistance in CRE. Early and accurate identification of carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE) is extremely important for the treatment and prevention of such infections. In the present study, four phenotypic carbapenemase detection tests were compared and an algorithm was developed for rapid and cost-effective identification of CP-CRE. A total of 117 Enterobacteriaceae (54 CP-CRE, 3 non-CP-CRE, and 60 non-CRE) isolates were tested for carbapenemase production using modified Hodge test (MHT), modified carbapenem inactivation method (mCIM), Carba NP test (CNPt), and CNPt-direct test. The overall sensitivity/specificity values were 90.7%/92.1% for MHT, 100%/100% for mCIM, 75.9%/100% for CNPt, and 83.3%/100% for CNPt-direct. OXA-48-like enzymes were detected with 93.2% sensitivity by MHT and >77.3% sensitivity by two Carba NP tests. MHT could only detect half of the NDM carbapenemase producers. CNPt-direct exhibited enhanced sensitivity compared to CNPt (100% vs 25%) for detection of NDM producers. Considering these findings we propose CNPt-direct as the first test followed by mCIM for rapid detection of CP-CRE. With this algorithm >80% of the CP-CRE could be detected within 24 hours from the time the sample is received and 100% CP-CRE could be detected in day two. In conclusion, mCIM was the most sensitive assay for the identification of CP-CRE. CNPt-direct performed better than CNPt. An algorithm consisting CNPt-direct and mCIM allows rapid and reliable detection of carbapenemase production in resource-limited settings.

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Section: Discussionsupporting

confidence: 90%

Comparison of four low-cost carbapenemase detection tests and a proposal of an algorithm for early detection of carbapenemase-producing Enterobacteriaceae in resource-limited settings

2021

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“…For the three GES producers, although two of them were defined as negative, while CNP and mCIM did not detect any of them, Fluore-C, Fluore-Direct, and CIT detected two, three, and two isolates, respectively. This finding was partly in line with a previous study (34) where the sensitivity for GES-4 producers was 0% in CNP and 17% in CIM but 100% in mCIM. In another study involving 22 GES-6 producers, the CIM showed a sensitivity of 50% (35).…”

Section: Discussionsupporting

confidence: 92%

“…The CLSI guideline stated that the CNP showed Ͼ90% sensitivity and mCIM showed Ͼ99% sensitivity when detecting class B carbapenemases, including NDM, VIM, and IMP, among Enterobacteriaceae isolates (28). Also, recent studies showed that the sensitivity for VIM producers was 85.7 to 100% with CNP, 71.4 to 100% with CIM, and 100% with mCIM (10,36,37) and the sensitivity for IMP producers was 93.8 to 100% with CNP, 93.8 to 100% with CIM, and 100% with mCIM (34,(38)(39)(40). Our results also coincided with these results.…”

Section: Discussionsupporting

confidence: 91%

Performance of a Novel Fluorogenic Assay for Detection of Carbapenemase-Producing Enterobacteriaceae from Bacterial Colonies and Directly from Positive Blood Cultures

Kim

Lee

et al. 2019

J Clin Microbiol

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Rapid and accurate detection of carbapenemase-producing Enterobacteriaceae (CPE) is critical for appropriate treatment and infection control. We compared a rapid fluorogenic assay using a carbapenem-based fluorogenic probe with other phenotypic assays: modified carbapenem inactivation method (mCIM), Carba NP test (CNP), and carbapenemase inhibition test (CIT). A total of 217 characterized isolates of Enterobacteriaceae were included as follows: 63 CPE; 48 non-carbapenemase-producing carbapenem-resistant Enterobacteriaceae (non-CP-CRE); 53 extended-spectrum β-lactamase producers; and 53 third-generation-cephalosporin-susceptible isolates. The fluorogenic assay using bacterial colonies (Fluore-C) was conducted by lysing the isolates followed by centrifugation and mixing the supernatant with fluorogenic probe. In addition, for the fluorogenic assay using spiked blood culture bottles (Fluore-Direct), pellets were obtained via the saponin preparation method, which can directly identify the pathogens using matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS). The fluorescence signal was measured over 50 min using a fluorometer. The fluorescent signal of CPE was significantly higher than that of non-CPE in both Fluore-C (median relative fluorescence units [RFU] [range], 5,814 [240 to 32,009] versus 804 [36 to 2,480], respectively; P < 0.0001) and Fluore-Direct (median RFU [range], 10,355 [1,689 to 31,463] versus 1,068 [428 to 2,155], respectively; P < 0.0001) tests. Overall, positive and negative percent agreements of Fluore-C, mCIM, CNP, CIT, and Fluore-Direct were 100% and 98.7%, 98.3% and 97.5%, 88.1% and 100%, 96.4% and 98.7%, and 98.3% and 98.1%, respectively. The relatively lower positive percent agreement (PPA) of CNP was mainly observed in OXA-type CPE. The fluorogenic assay showed excellent performance with bacterial colonies and also directly from positive blood cultures. We included many non-CP-CRE isolates for strict evaluation. The fluorogenic assay will be a useful tool for clinical microbiology laboratories.

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“…The modified CIM (mCIM) became the CLSI-recommended method in 2017. A study indicated that both the sensitivity and specificity of mCIM were 100% (Kuchibiro et al, 2018). Because of its simplicity, clear criteria, cost-effectiveness, and availability in any laboratory, the mCIM has become a useful tool in microbiology laboratories.…”

Section: Rapid Detection Of Carbapenemasesmentioning

confidence: 99%

Carbapenemases in Enterobacteriaceae: Detection and Antimicrobial Therapy

2019

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Carbapenem-resistant Enterobacteriaceae (CRE) have spread rapidly around the world in the past few years, posing great challenges to human health. The plasmid-mediated horizontal transmission of carbapenem-resistance genes is the main cause of the surge in the prevalence of CRE. Therefore, the timely and accurate detection of CRE, especially carbapenemase-producing Enterobacteriaceae, is very important for the clinical prevention and treatment of these infections. A variety of methods for the rapid detection of CRE phenotypes and genotypes have been developed for use in clinical microbiology laboratories. To overcome the lack of efficient antibiotics, CRE infections are often treated with combination therapies. Moreover, novel drugs and emerging strategies appeared successively and in various stages of development. In this article, we summarized the global distribution of various carbapenemases. And we focused on summarizing and comparing the advantages and limitations of the detection methods and the therapeutic strategies of CRE primarily.

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Evaluation of the modified carbapenem inactivation method for the detection of carbapenemase-producing Enterobacteriaceae

Cited by 30 publications

References 18 publications

Comparison of four low-cost carbapenemase detection tests and a proposal of an algorithm for early detection of carbapenemase-producing Enterobacteriaceae in resource-limited settings

Comparison of four low-cost carbapenemase detection tests and a proposal of an algorithm for early detection of carbapenemase-producing Enterobacteriaceae in resource-limited settings

Performance of a Novel Fluorogenic Assay for Detection of Carbapenemase-Producing Enterobacteriaceae from Bacterial Colonies and Directly from Positive Blood Cultures

Carbapenemases in Enterobacteriaceae: Detection and Antimicrobial Therapy

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