Performance of chromID® CARBA-SMART medium and carbapenemase inhibition method for the detection of carbapenemases among Gram negative bacilli

Background:Early detection of carbapenemase enzymes among Gram negative bacilli (GNB) is mandatory to prevent their spread. Objective: The goal of this study was to evaluate the performance of chromID® CARBA-SMART medium and carbapenemase inhibition method (CIM) for detection of carbapenemases in GN...

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Bibliographic Details
Published in:Microbes and Infectious Diseases 2022-05, Vol.3 (2), p.366-377
Main Authors: Aliaa Ghandour, Wegdan Mohamad, Rania Bakry, Asmaa Ahmed, Nahla Elsherbiny
Format: Article
Language:English
Subjects:
carbapenemase
genes
inhibition
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Summary:Background:Early detection of carbapenemase enzymes among Gram negative bacilli (GNB) is mandatory to prevent their spread. Objective: The goal of this study was to evaluate the performance of chromID® CARBA-SMART medium and carbapenemase inhibition method (CIM) for detection of carbapenemases in GNB. Methodology: A total of 142 GNB isolates were collected and tested using Vitek-2® system for identification and antimicrobial susceptibility testing The carbapenem resistant (CR) GNB were tested for carbapenemase production by phenotypic methods; chromID® CARBA-SMART medium and CIM. Carbapenemase genes (blaNDM-1, blaSIM-1,blaVIM-2, blaKPC-1, blaGIM-1, blaSPM-1 and blaOXA-48) were detected by PCR. Results: By minimal inhibitory concentration (MIC), 111 (78.17 %) of the 142 isolates were shown to be carbapenem resistant. Sensitivity and specificity of CIM and ChromID® CARBA-SMART medium were (100% and 66.7% respectively) for CIM and (86.7% and 100% respectively) for the medium. Resistance to carbapenem was associated with high percentages of resistance to many antibiotic classes. Carbapenemase genes were detected in 82% (91/111) of CR GNB with blaNDM-1 (58.6%) and blaOXA-48 (55.9 %) having the highest prevalence, followed by blaKPC-1 (36 %) then blaVIM-2 (10.8%) and lastly blaSPM-1 (3.6 %) and blaSIM-1 (1.8 %). The blaGIM-1 gene was not detected in any isolate. Conclusion: Carbapenemase inhibition method was found to be a very sensitive, easy, and cheap test for carbapenemase detection but needs the addition of ChromID® CARBA-SMART medium to improve the specificity of the test. This study has a high prevalence of carbapenemases among isolates with potential of rapid spread necessitating need for phenotypic tests.
ISSN:2682-4132
2682-4140
DOI:10.21608/mid.2022.118857.1242