Carbapenemase-resistant Enterobacteriaceae (CRE) cause many serious infections resulting in increasing treatment cost, prolonged hospitalization, and mortality rate. Reduced expression and/or mutations of porins and the presence of carbapenemase promote Enterobacteriaceae survival under carbapenem treatments. Development of accurate methods for the detection of antimicrobial resistance is required not only for therapy but also to monitor the spread of resistant bacteria or resistance genes throughout the hospital and community. In this study, we aimed to evaluate the phenotypic methods, Modified Hodge test (MHT), modified carbapenem inactivation method (mCIM), and EDTA-CIM (eCIM) for the detection of carbapenemase-producing Enterobacteriaceae (CPE). The results showed that mCIM had a sensitivity of 100% and a specificity of 100%, whereas the MHT had a sensitivity of 84.8% and a specificity of 97.8% for the 195 CRE isolates tested (105 CPE and 90 non-CPE isolates). The sensitivity of the mCIM/eCIM to detect metallo-carbapenemases in this study was 89.3% and the specificity was 98.7% as compared to the genotypic PCR detection. These findings indicate that the mCIM combined with eCIM is useful for detecting and distinguishing different types of carbapenemase in Enterobacteriaceae.

中文翻译：

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改良碳青霉烯灭活法 (mCIM) 与 EDTA-CIM (eCIM) 组合用于产碳青霉烯酶肠杆菌科细菌的表型检测

耐碳青霉烯酶肠杆菌科 (CRE) 引起许多严重感染，导致治疗费用增加、住院时间延长和死亡率增加。减少的孔蛋白表达和/或突变以及碳青霉烯酶的存在促进肠杆菌科在碳青霉烯治疗下的存活。开发用于检测抗微生物药物耐药性的准确方法不仅需要治疗，还需要监测耐药细菌或耐药基因在整个医院和社区的传播。在本研究中，我们旨在评估表型方法、改良 Hodge 试验 (MHT)、改良碳青霉烯灭活法 (mCIM) 和 EDTA-CIM (eCIM) 用于检测产碳青霉烯酶的肠杆菌科 (CPE)。结果表明，mCIM的敏感性为100%，特异性为100%，而 MHT 对于测试的 195 个 CRE 分离株（105 个 CPE 和 90 个非 CPE 分离株）的敏感性为 84.8%，特异性为 97.8%。与基因型 PCR 检测相比，本研究中 mCIM/eCIM 检测金属碳青霉烯酶的灵敏度为 89.3%，特异性为 98.7%。这些发现表明 mCIM 与 eCIM 结合可用于检测和区分肠杆菌科细菌中不同类型的碳青霉烯酶。