Introduction. Carbapenem resistant Enterobacterales (CRE) are one of the leading causes of systemic and nosocomial infections and are multidrug-resistant organisms producing different carbapenemases. There are many genotypic and phenotypic methods for detecting the carbapenemases; however, there is a limitation for each. Modified carbapenem inactivation method (mCIM) assay is a recent phenotypic method which has been published by the Clinical and Laboratory Standards Institute. Hypothesis / Gap Statement. mCIM assay could provide a reliable method for the detection of carbapenemases in CRE. Aim. Evaluation of the mCIM assay performance for the detection of carbapenemases in Enterobacterales and the identification of the common carbapenemase genes at Eastern Province of Saudi Arabia and Kingdom of Bahrain. Methodology. A collection of 197 non-duplicate carbapenem resistant Enterobacterales clinical isolates, were evaluated with the mCIM test comparing its performance to multiplex PCR. The minimum inhibitory concentration susceptibility testing was done by the Etest method for imipenem, meropenem, and ertapenem. Results. The sensitivity of the mCIM assay was 94 % (95 % CI, (89.3–97.1)). In Saudi Arabia and Bahrain, OXA-48 was the most prevalent carbapenemase gene followed by NDM. Coexistence of multiple carbapenemase genes is reported in eleven cases. Conclusion. These findings indicate that the mCIM test is a reliable and simple assay for detecting the activity of carbapenemase in Enterobacterales , especially in resource-limited laboratories.

中文翻译：

---

mCIM 测试是检测海湾地区 CRE 的可靠方法

介绍。耐碳青霉烯肠杆菌(CRE) 是全身和医院感染的主要原因之一，是产生不同碳青霉烯酶的多重耐药菌。检测碳青霉烯酶的基因型和表型方法很多；但是，每个都有限制。改良的碳青霉烯灭活方法 (mCIM) 测定是最近由临床和实验室标准研究所公布的表型方法。假设/差距陈述。mCIM 检测可为 CRE 中碳青霉烯酶的检测提供可靠的方法。目标。评估 mCIM 检测肠杆菌中碳青霉烯酶的性能 沙特阿拉伯东部省和巴林王国常见碳青霉烯酶基因的鉴定。方法。使用 mCIM 测试评估了197 个非重复的碳青霉烯类耐药肠杆菌临床分离株的集合，并将其性能与多重 PCR 进行比较。亚胺培南、美罗培南和厄他培南的最低抑菌浓度药敏试验采用Etest法。结果。mCIM 检测的灵敏度为 94%（95% CI，(89.3–97.1)）。在沙特阿拉伯和巴林，OXA-48 是最普遍的碳青霉烯酶基因，其次是 NDM。在 11 个病例中报告了多种碳青霉烯酶基因的共存。结论。 这些发现表明，mCIM 测试是一种可靠且简单的检测方法，用于检测肠杆菌中碳青霉烯酶的活性，尤其是在资源有限的实验室中。