Arumugam Kumuda, Karande Geeta S, Patil Satish R
Department of Microbiology, Krishna Vishwa Vidyapeeth (Deemed to be University), Satara, IND.
Cureus. 2024 Oct 6;16(10):e70918. doi: 10.7759/cureus.70918. eCollection 2024 Oct.
Background and aim Urinary tract infections represent a substantial portion of healthcare-associated infections due to and . Carbapenems are broad-spectrum antibiotics considered highly effective in treating infections caused by multidrug-resistant bacteria. Carbapenem-resistant CRE), including carbapenem-producing and isolates, have become a major concern as they limit treatment options. The study aims to determine the prevalence of carbapenemase-producing and while also comparing the effectiveness of two detection methods, namely the modified carbapenem inactivation method (mCIM) and modified Hodge test (MHT). Materials and methods A cross-sectional study was conducted from July 2022 to June 2023 in a tertiary care hospital, in Karad, Satara, India. Three hundred urinary isolates of (150) and (150) were studied. These isolates were tested for antimicrobial susceptibility testing. Two phenotypic methods, the modified carbapenem inactivation method (mCIM) and the modified Hodge test (MHT), were used to study carbapenemase production. Results Out of three hundred isolates, carbapenemase production was detected in 72 isolates (24%) by the modified Hodge test (MHT) and in 111 isolates (37%) by the modified carbapenem inactivation method (mCIM). Among the MHT-positive isolates, 46 (63.8%) were identified as and 26 (36.1%) as . In contrast, of the mCIM-positive isolates, 68 (61.2%) were , and 43 (38.7%) were . A total of 41 (27.33%) and 25 (16.66%) isolates tested positive by both methods, highlighting variability in detection rates between the two methods. Conclusion This study observed MHT and mCIM to be accurate for the detection of carbapenemase among carbapenem-resistant isolates. However, the mCIM demonstrated greater sensitivity compared to the MHT.
背景与目的 由于[具体原因1]和[具体原因2]，尿路感染在医疗保健相关感染中占很大比例。碳青霉烯类是被认为对治疗多重耐药菌引起的感染非常有效的广谱抗生素。耐碳青霉烯类肠杆菌科细菌（CRE），包括产碳青霉烯酶的[细菌种类1]和[细菌种类2]分离株，由于其限制了治疗选择，已成为一个主要问题。本研究旨在确定产碳青霉烯酶的[细菌种类1]和[细菌种类2]的流行率，同时比较两种检测方法的有效性，即改良碳青霉烯灭活法（mCIM）和改良 Hodge 试验（MHT）。
材料与方法 2022 年 7 月至 2023 年 6 月在印度萨塔拉卡拉德的一家三级护理医院进行了一项横断面研究。研究了 300 株[细菌种类1]（150 株）和[细菌种类2]（150 株）的尿液分离株。对这些分离株进行了抗菌药物敏感性测试。使用两种表型方法，即改良碳青霉烯灭活法（mCIM）和改良 Hodge 试验（MHT）来研究碳青霉烯酶的产生。
结果 在 300 株分离株中，改良 Hodge 试验（MHT）检测到 72 株（24%）产碳青霉烯酶，改良碳青霉烯灭活法（mCIM）检测到 111 株（37%）产碳青霉烯酶。在 MHT 阳性分离株中，46 株（63.8%）被鉴定为[细菌种类1]，26 株（36.1%）为[细菌种类2]。相比之下，在 mCIM 阳性分离株中，68 株（61.2%）为[细菌种类1]，43 株（38.7%）为[细菌种类2]。共有 41 株（27.33%）[细菌种类1]和 25 株（16.66%）[细菌种类2]分离株两种方法检测均为阳性，突出了两种方法检测率的差异。
结论 本研究观察到 MHT 和 mCIM 对于检测耐碳青霉烯类分离株中的碳青霉烯酶是准确的。然而，与 MHT 相比，mCIM 表现出更高的敏感性。
