An improved carbapenem inactivation method, CIMTrisII, for carbapenemase production by Gram-negative pathogens.

The modified carbapenem inactivation method (mCIM) is a simple phenotypic screening method for detecting carbapenemase production by Enterobacteriaceae and Pseudomonas aeruginosa. We recently developed another modified carbapenem inactivation method (CIMTris), in which carbapenemase is extracted from bacteria with Tris-HCl buffer, to detect carbapenemase production by Acinetobacter and Pseudomonas species. This study describes an improved carbapenem inactivation method, CIMTrisll, for detecting carbapenemase production by Gram-negative pathogens, including Enterobacteriaceae, Acinetobacter and Pseudomonas species. CIMTrisll was different from CIMTris in the concentration of Meropenem disks (5-mu g MEM disks vs. 10-mu g MEM disks), the inoculum volume of the bacteria (a 5-mu l loopful vs. a 10 mu l loopful) and the incubation time (1 vs. 2 h). CIMTrisll showed an overall sensitivity of 99.3 % and an overall specificity of 95.0 % for tested isolates. In comparison, CIMTris showed a sensitivity of 96.1 % and a specificity of 96.3 %, and mCIM showed a sensitivity of 67.1 % and a specificity of 100 %. CIMTrisll is thus deemed useful for detecting carbapenemase production by Gram-negative pathogens.