EDTA-Modified Carbapenem Inactivation Method: a Phenotypic Method for Detecting Metallo-β-Lactamase-Producing Enterobacteriaceae

J Clin Microbiol. 2019 Apr 26;57(5):e01757-18. doi: 10.1128/JCM.01757-18. Print 2019 May.

Abstract

The increase in the prevalence and impact of infections caused by carbapenemase-producing Enterobacteriaceae is a global health concern. Therefore, rapid and accurate methods to detect these organisms in any clinical microbiology laboratory, including those in resource-limited settings, are essential to prevent and contain their spread. It is also important to differentiate between serine- and metal-dependent carbapenemases elaborated by carbapenemase-producing isolates for epidemiologic, infection control and prevention, and therapeutic purposes. Here, we describe the development and evaluation of the EDTA-modified carbapenem inactivation method (eCIM), an assay for discriminating between serine- and metal-dependent (i.e., metallo-β-lactamases [MBLs]) carbapenemases when used in conjunction with the modified carbapenem inactivation method (mCIM). The eCIM had an overall sensitivity and specificity of 100% and was adopted by the Clinical and Laboratory Standards Institute as a method to use in combination with the mCIM to identify MBL-producing Enterobacteriaceae.

Keywords: EDTA-modified carbapenem inactivation method; MBL; carbapenemase; carbapenemase-producing Enterobacteriaceae; eCIM; mCIM; metallo-β-lactamase; modified carbapenem inactivation method; phenotypic detection.

Publication types

  • Evaluation Study

MeSH terms

  • Anti-Bacterial Agents / chemistry
  • Biological Assay / methods*
  • Biological Assay / standards
  • Carbapenem-Resistant Enterobacteriaceae / drug effects
  • Carbapenem-Resistant Enterobacteriaceae / isolation & purification*
  • Carbapenems / chemistry*
  • Edetic Acid / chemistry*
  • Metals
  • Microbial Sensitivity Tests
  • Phenotype
  • Sensitivity and Specificity
  • Serine
  • beta-Lactamases / classification*
  • beta-Lactamases / isolation & purification

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Metals
  • Serine
  • Edetic Acid
  • beta-Lactamases