IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
Service de Microbiologie, Hôpital Saint-Louis, AP-HP, Paris, France.
J Clin Microbiol. 2018 Aug 27;56(9). doi: 10.1128/JCM.00137-18. Print 2018 Sep.
The dissemination of carbapenemase-producing (CPE) is a major threat to public health. Rapid and accurate detection of CPE is essential for initiating appropriate antimicrobial treatment and establishing infection control measures. The carbapenem inactivation method (CIM), which has good sensitivity and specificity but a detection time of 20 h, was recently described. In this study, we evaluated the performances of a new version, the CIMplus test, which allows detection of carbapenemases in 8 h and characterization of carbapenemase classes, according to the Ambler classification, in 20 h. A panel of 110 carbapenem-resistant strains, including 92 CPE strains (with NDM, VIM, IMP, KPC, GES, OXA-48, and OXA-48-like enzymes), was used to evaluate test performance. Carbapenemase activity was detected at 8 h and 20 h. Characterization of carbapenemase classes, using specific inhibitors, was possible in 20 h. The CIMplus test had sensitivities of 95.7% and 97.8% at 8 h and 20 h, respectively, and a specificity of 94.4%, independent of the culture duration. Using a decision algorithm, this test was successful in identifying the carbapenemase class for 98.9% of tested CPE isolates (87/88 isolates). In total, the characterization was correct for 100%, 96.9%, and 100% of Ambler class A, B, and D isolates, respectively. Therefore, this test allows detection of carbapenemase activity in 8 h and characterization of carbapenemase classes, according to the Ambler classification, in 20 h. The CIMplus test represents a simple, affordable, easy-to-read, and accurate tool that can be used without any specific equipment.
产碳青霉烯酶（CPE）的传播对公共健康构成了重大威胁。快速准确地检测 CPE 对于启动适当的抗菌治疗和建立感染控制措施至关重要。最近描述了一种具有良好敏感性和特异性但检测时间为 20 小时的碳青霉烯失活法（CIM）。在这项研究中，我们评估了新版本 CIMplus 测试的性能，该测试允许在 8 小时内检测碳青霉烯酶，并根据 Ambler 分类在 20 小时内表征碳青霉烯酶类别。使用包括 92 株 CPE 菌株（含 NDM、VIM、IMP、KPC、GES、OXA-48 和 OXA-48 样酶）的 110 株耐碳青霉烯菌株的药敏试验来评估测试性能。在 8 小时和 20 小时检测到碳青霉烯酶活性。使用特定抑制剂在 20 小时内可对碳青霉烯酶类别进行特征分析。CIMplus 测试在 8 小时和 20 小时的敏感性分别为 95.7%和 97.8%，特异性为 94.4%，与培养时间无关。使用决策算法，该测试成功地识别了 98.9%（87/88 株）测试的 CPE 分离株的碳青霉烯酶类别。总的来说，该测试对 Ambler 类 A、B 和 D 分离株的特征分析分别为 100%、96.9%和 100%正确。因此，该测试允许在 8 小时内检测碳青霉烯酶活性，并在 20 小时内根据 Ambler 分类对碳青霉烯酶类别进行特征分析。CIMplus 测试是一种简单、经济实惠、易于阅读和准确的工具，无需任何特定设备即可使用。
