title: Strengths and limitations of various screening methods for carbapenem-resistantEnterobacteriaceaeincluding new method recommended by clinical and laboratory standards institute, 2017: A tertiary care experience.
abstract: Carbapenemase-mediated carbapenem resistance is a major concern across the world. Rapid detection of carbapenemase-producing organisms is of great importance in clinical settings. However, it is essential to have a test with good sensitivity and specificity. The aim of the study was to compare the performance of RAPIDEC® CARBA NP and modified carbapenem inactivation method (mCIM) recommended by Clinical and Laboratory Standards Institute guideline 2017. A total of ninety carbapenem resistant Escherichia coli and Klebsiella pneumoniae have been tested. The presence of various carbapenemases was screened by conventional multiplex polymerase chain reaction. RAPIDEC® CARBA NP detected 90%, whereas mCIM detected 99% of the study isolates tested. Although RAPIDEC® CARBA NP is a rapid test, the sensitivity is reduced for blaOxa-48Likedetection; while mCIM could pick up blaOxa-48Likeenzymes with excellent sensitivity. Further, organisms producing low carbapenemase activity enzymes, thickness of the inoculum and the disc potency are likely to influence the test results of mCIM with an overnight delay.
authors.affiliation: Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Agila Kumari
authors.initials: AK
authors.lastname: Pragasam
authors.affiliation: Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Balaji
authors.initials: B
authors.lastname: Veeraraghavan
authors.affiliation: Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Yamuna Devi
authors.initials: YD
authors.lastname: Bakthavatchalam
authors.affiliation: Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Radha
authors.initials: R
authors.lastname: Gopi
authors.affiliation: Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Raziya Fathima
authors.initials: RF
authors.lastname: Aslam
mesh_terms: D001426:Bacterial Proteins / Q000032:analysis*; D004756:Enterobacteriaceae Infections / Q000382:microbiology*; D004926:Escherichia coli / Q000201:enzymology* / Q000302:isolation & purification; D006801:Humans; D007711:Klebsiella pneumoniae / Q000201:enzymology* / Q000302:isolation & purification; D008403:Mass Screening / Q000379:methods*; D008826:Microbial Sensitivity Tests / Q000379:methods*; D012680:Sensitivity and Specificity; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000032:analysis*
chemical_list: D001426:Bacterial Proteins; D001618:beta-Lactamases; C063912:carbapenemase