Investigating the validity of mCIM and sCIM phenotypic methods in screening Pseudomonas aeruginosa isolates producing IMP, VIM, and NDM metallo-beta-lactamases isolated from burn wounds.

Abstract

Metallo-beta-lactamase-producing Pseudomonas aeruginosa (P. aeruginosa) is a major pathogen in burn wounds, often exhibiting high levels of antibiotic resistance, which complicates treatment strategies. This study deals with the validity of the modified Carbapenem Inactivation Method (mCIM) and the simplified Carbapenem Inactivation Method (sCIM) phenotypic tests for screening metallo-beta-lactamase (MBL) production by P. aeruginosa isolates from a referral burn center in Iran. Forty isolates were obtained between January and June 2021 and identified using conventional biochemical methods. Antimicrobial susceptibility testing was conducted following Clinical and Laboratory Standards Institute (CLSI) 2021 guidelines. mCIM based on CLSI 2023 guidelines was used to detect carbapenemase production. sCIM was also used based on previously developed protocols. PCR was performed to detect bla_IMP, bla_VIM, and bla_NDM genes. The results were analyzed using SPSS and MedCalc. We observed a 90% resistance rate to imipenem and high resistance to other antibiotics, with multidrug-resistant (MDR) strains constituting 95% of the isolates. The mCIM test demonstrated high sensitivity (87.50%) and high negative predictive value (89.47%) and moderate specificity (70.83%) and moderate positive predictive value (66.67%) for detecting MBLs. In contrast, the sCIM test was unreliable, indicating a need for more standardized testing protocols. This study underscores the importance of accurate and timely detection of carbapenemase production to guide effective treatment.