{"title":"Detection of carbapenemase production in Enterobacterales by mCIM and eCIM: a tertiary care hospital study.","authors":"Touseefa Shafi, Anjum Ara Mir, Shagufta Roohi, Bashir Fomda, Sanam Rasool Wani, Tufail Ahmed, Samiah Yousuf","doi":"10.18502/ijm.v17i4.19227","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>Carbapenem-resistant Enterobacterales (CRE) pose a major healthcare challenge due to high resistance rates and limited treatment options. This study characterized carbapenemase production among CRE isolates using phenotypic methods-Modified Carbapenem Inactivation Method (mCIM) and EDTA-Carbapenem Inactivation Method (eCIM)-as genotypic methods have limitations like restricted gene targets and mutations.</p><p><strong>Materials and methods: </strong>This six-month study was conducted at Sher-i-Kashmir Institute of Medical Sciences (SKIMS). Samples including swabs, respiratory specimens, pus, body fluids, and blood were cultured on Blood Agar and MacConkey Agar (HiMedia, India). Enterobacterales were identified using conventional methods and screened for carbapenem resistance. CRE isolates underwent mCIM and eCIM testing per CLSI guidelines.</p><p><strong>Results: </strong>Among 471 Enterobacterales isolates tested, 160 (33.9%) were carbapenem-resistant. Of these, 97 (60.6%) were mCIM positive, indicating carbapenemase production. eCIM further identified 83 (85.5%) as metallo-beta-lactamase (MBL) producers and 14 (14.4%) as serine carbapenemase producers. CRE prevalence was higher in ICU settings and among males. Isolates showed high cephalosporin resistance, with multi-drug resistance (MDR) common in both MBL and serine carbapenemase producers.</p><p><strong>Conclusion: </strong>The prevalence of CRE was found to be 33.9%. The findings underscore the critical need for continuous surveillance and stringent infection control measures to manage the spread of CRE in healthcare settings.</p>","PeriodicalId":14633,"journal":{"name":"Iranian Journal of Microbiology","volume":"17 4","pages":"539-548"},"PeriodicalIF":1.7000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331457/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Iranian Journal of Microbiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18502/ijm.v17i4.19227","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MICROBIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and objectives: Carbapenem-resistant Enterobacterales (CRE) pose a major healthcare challenge due to high resistance rates and limited treatment options. This study characterized carbapenemase production among CRE isolates using phenotypic methods-Modified Carbapenem Inactivation Method (mCIM) and EDTA-Carbapenem Inactivation Method (eCIM)-as genotypic methods have limitations like restricted gene targets and mutations.
Materials and methods: This six-month study was conducted at Sher-i-Kashmir Institute of Medical Sciences (SKIMS). Samples including swabs, respiratory specimens, pus, body fluids, and blood were cultured on Blood Agar and MacConkey Agar (HiMedia, India). Enterobacterales were identified using conventional methods and screened for carbapenem resistance. CRE isolates underwent mCIM and eCIM testing per CLSI guidelines.
Results: Among 471 Enterobacterales isolates tested, 160 (33.9%) were carbapenem-resistant. Of these, 97 (60.6%) were mCIM positive, indicating carbapenemase production. eCIM further identified 83 (85.5%) as metallo-beta-lactamase (MBL) producers and 14 (14.4%) as serine carbapenemase producers. CRE prevalence was higher in ICU settings and among males. Isolates showed high cephalosporin resistance, with multi-drug resistance (MDR) common in both MBL and serine carbapenemase producers.
Conclusion: The prevalence of CRE was found to be 33.9%. The findings underscore the critical need for continuous surveillance and stringent infection control measures to manage the spread of CRE in healthcare settings.
期刊介绍：
The Iranian Journal of Microbiology (IJM) is an international, multi-disciplinary, peer-reviewed journal that provides rapid publication of the most advanced scientific research in the areas of basic and applied research on bacteria and other micro-organisms, including bacteria, viruses, yeasts, fungi, microalgae, and protozoa concerning the development of tools for diagnosis and disease control, epidemiology, antimicrobial agents, clinical microbiology, immunology, Genetics, Genomics and Molecular Biology. Contributions may be in the form of original research papers, review articles, short communications, case reports, technical reports, and letters to the Editor. Research findings must be novel and the original data must be available for review by the Editors, if necessary. Studies that are preliminary, of weak originality or merely descriptive as well as negative results are not appropriate for the journal. Papers considered for publication must be unpublished work (except in an abstract form) that is not under consideration for publication anywhere else, and all co-authors should have agreed to the submission. Manuscripts should be written in English.
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