Karbapenem İnaktivasyon Testi
Özet
Karbapenemazların doğru ve hızlı bir şekilde tanımlanması, hem hasta hem de halk sağlığı açısından büyük öneme sahiptir. Carbapenem Inactivation Test (CIM), European Committee on Antimicrobial Susceptibility Testing (EUCAST) ve Clinical Laboratory Standards Institute (CLSI) gibi uluslararası rehberler tarafından önerilen fenotipik bir yöntemdir. Bu test, karbapenem sınıfı bir antibiyotiğin, test edilen bakteri tarafından üretilen karbapenemaz tarafından inaktive edilip edilmediğinin gösterilmesine dayanmaktadır. CIM, güvenilir, maliyet etkin, uygulanması ve yorumlanması kolay bir test olarak tanımlanmıştır. CIM’ın performansını artırmak amacıyla çeşitli parametrelerde değişiklikler yapılarak çok sayıda türevleri geliştirilmiştir. Bu derlemede, CIM’ın avantajları, dezavantajları ve literatürde tanımlanan başlıca türevleri, güncel bilgiler ışığında irdelenmiştir.
Accurate and rapid identification of carbapenemases is of critical importance for both patient and public health. Carbapenem Inactivation Test (CIT) is a phenotypic method recommended by international guidelines such as those of the European Committee on Antimicrobial Susceptibility Testing (EUCAST) and the Clinical Laboratory Standards Institute (CLSI) for the detection of carbapenemases. This test is based on demonstrating whether a carbapenem-class antibiotic is inactivated by a carbapenemase enzyme produced by the tested bacterium. CIM has been described as a reliable, cost-effective test that is easy to perform and interpret. To improve its performance, numerous modifications have been developed by altering various parameters. In this review, the advantages and disadvantages of the CIM and its major modifications described in the literature are reviewed in the light of current knowledge.
Referanslar
Lee YL, Chen HM, Hii IM, Hsueh PR. Carbapenemase-producingEnterobacterales infections: recent advances in diagnosis and treatment. Int J Antimicrob Agents. 2022;59(2):106528. https://doi.org/10.1016/j.ijantimicag.2022.106528
van der Zwaluw K, de Haan A, Pluister GN, Bootsma HJ, de Neeling AJ, Schouls LM. The carbapenem inactivation method (CIM), a simple and low-cost alternative for the Carba NP test to assess phenotypic carbapenemase activity in gram-negative rods. PLoS One. 2015; 10(3):e0123690. https://doi.org/10.1371/journal.pone.0123690
Humphries RM. CIM City: the Game Continues for a Better Carbapenemase Test. J Clin Microbiol. 2019;57(7):e00353-19. https://doi.org/10.1128/JCM.00353-19
Noster J, Thelen P, Hamprecht A. Detection of Multidrug-Resistant Enterobacterales-From ESBLs to Carbapenemases. Antibiotics (Basel) 2021;10(9):1140. https://doi.org/10.3390/antibiotics10091140
Bayramoğlu G, Uluçam G, Gençoğlu Özgür Ç. Evaluation of carbapenem inactivation method for the identification of carbapenemase-producing Enterobacteriaceae strains. Mikrobiyol Bul. 2016;50(3):505-7. https://doi.org/10.5578/mb.26497
Tamma PD, Simner PJ. Phenotypic Detection of Carbapenemase-Producing Organisms from Clinical Isolates. J Clin Microbiol. 2018;56(11): e01140-18. https://doi.org/10.1128/JCM.01140-18
Sfeir MM, Hayden JA, Fauntleroy KA, Manzur C, Johnson JK, Simner PJ, et al. EDTA-Modified Carbapenem Inactivation Method: a Phenotypic Method for Detecting Metallo-β-Lactamase-Producing Enterobacteriaceae. J Clin Microbiol. 2019;57(5):e01757-18. https://doi.org/10.1128/JCM.01757-18
Rizvi M, Sami H, Azam M, Khalid DB, Jabri ZA, Khan F, et al. Reliability of carbapenem inactivation method (CIM) and modified carbapenem inactivation method (mCIM) for detection of OXA-48-like and NDM-1. Indian J Med Microbiol. 2021;39(4):451-456. https://doi.org/10.1016/j.ijmmb.2021.07.004
Pierce VM, Simner PJ, Lonsway DR,Roe Carpenter DE, Johnson JK, Brasso WB, et al. Modified Carbapenem Inactivation Method for Phenotypic Detection of Carbapenemase Production among Enterobacteriaceae. J Clin Microbiol. 2017;55(8):2321-2333. https://doi.org/10.1128/JCM.00193-17
CLSI. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. CLSI supplement M100. 36th ed. Wayne (PA), ABD: CLSI; 2026. Erişim tarihi: 07.02.2026.
Simner PJ, Johnson JK, Brasso WB, Anderson K, Lonsway DR, Pierce VM, et al. Multicenter Evaluation of the Modified Carbapenem Inactivation Method and the Carba NP for Detection of Carbapenemase-Producing Pseudomonas aeruginosa and Acinetobacter baumannii. J Clin Microbiol 2017;56(1): e01369-17. https://doi.org/10.1128/JCM.01369-17
Jing X, Zhou H, Min X, Zhang X, Yang Q, Du S, et al. The Simplified Carbapenem Inactivation Method (sCIM) for Simple and Accurate Detection of Carbapenemase-Producing Gram-Negative Bacilli. Front Microbiol. 2018;9: 2391. https://doi.org/10.3389/fmicb.2018.02391
Zhang S, Mi P, Wang J, Li P, Luo K, Liu S, et al. The optimized carbapenem inactivation method for objective and accurate detection of carbapenemase-producing Acinetobacter baumannii. Front Microbiol. 2023;14:1185450. https://doi.org/10.3389/fmicb.2023.1185450
Tsai YM, Wang S, Chiu HC, Kao CY, Wen LL. Combination of modified carbapenem inactivation method (mCIM) and EDTA-CIM (eCIM) for phenotypic detection of carbapenemase-producing Enterobacteriaceae. BMC Microbiol. 2020 Oct 17;20(1):315. https://doi.org/10.1186/s12866-020-02010-3
Baeza LL, Pfennigwerth N, Greissl C, Göttig S, Saleh A, Stelzer Y, et al. Comparison of five methods for detection of carbapenemases in Enterobacterales with proposal of a new algorithm. Clin Microbiol Infect. 2019; 25(10):1286.e9-1286.e15. https://doi.org/10.1016/j.cmi.2019.03.003
Meier M, Hamprecht A. Systematic Comparison of Four Methods for Detection of Carbapenemase-Producing Enterobacterales Directly from Blood Cultures. J Clin Microbiol. 2019;57(11):e00709-19. https://doi.org/10.1128/JCM.00709-19
Suriya R V, Kv L, Feliciana J H, R A. Diagnostic Test Precision of Modified Carbapenem Inactivation Method and Carbapenemase Nordmann-Poirel Test for Phenotypic Detection of Carbapenemase Production in Enterobacterales: A Systematic Review. Cureus. 2024;16(8):e67322. https://doi.org/10.7759/cureus.67322
Verma G, Singh N, Smriti S, Panda SS, Pattnaile D, Tripathy S, et al. Modified Carbapenem Inactivation Method and Ethylenediaminetetraacetic Acid (EDTA)-Carbapenem Inactivation Method for Detection of Carbapenemase-Producing Enterobacterales and Pseudomonas aeruginosa. Cureus. 2024;16(6):e63340. https://doi.org/10.7759/cureus.63340
Referanslar
Lee YL, Chen HM, Hii IM, Hsueh PR. Carbapenemase-producingEnterobacterales infections: recent advances in diagnosis and treatment. Int J Antimicrob Agents. 2022;59(2):106528. https://doi.org/10.1016/j.ijantimicag.2022.106528
van der Zwaluw K, de Haan A, Pluister GN, Bootsma HJ, de Neeling AJ, Schouls LM. The carbapenem inactivation method (CIM), a simple and low-cost alternative for the Carba NP test to assess phenotypic carbapenemase activity in gram-negative rods. PLoS One. 2015; 10(3):e0123690. https://doi.org/10.1371/journal.pone.0123690
Humphries RM. CIM City: the Game Continues for a Better Carbapenemase Test. J Clin Microbiol. 2019;57(7):e00353-19. https://doi.org/10.1128/JCM.00353-19
Noster J, Thelen P, Hamprecht A. Detection of Multidrug-Resistant Enterobacterales-From ESBLs to Carbapenemases. Antibiotics (Basel) 2021;10(9):1140. https://doi.org/10.3390/antibiotics10091140
Bayramoğlu G, Uluçam G, Gençoğlu Özgür Ç. Evaluation of carbapenem inactivation method for the identification of carbapenemase-producing Enterobacteriaceae strains. Mikrobiyol Bul. 2016;50(3):505-7. https://doi.org/10.5578/mb.26497
Tamma PD, Simner PJ. Phenotypic Detection of Carbapenemase-Producing Organisms from Clinical Isolates. J Clin Microbiol. 2018;56(11): e01140-18. https://doi.org/10.1128/JCM.01140-18
Sfeir MM, Hayden JA, Fauntleroy KA, Manzur C, Johnson JK, Simner PJ, et al. EDTA-Modified Carbapenem Inactivation Method: a Phenotypic Method for Detecting Metallo-β-Lactamase-Producing Enterobacteriaceae. J Clin Microbiol. 2019;57(5):e01757-18. https://doi.org/10.1128/JCM.01757-18
Rizvi M, Sami H, Azam M, Khalid DB, Jabri ZA, Khan F, et al. Reliability of carbapenem inactivation method (CIM) and modified carbapenem inactivation method (mCIM) for detection of OXA-48-like and NDM-1. Indian J Med Microbiol. 2021;39(4):451-456. https://doi.org/10.1016/j.ijmmb.2021.07.004
Pierce VM, Simner PJ, Lonsway DR,Roe Carpenter DE, Johnson JK, Brasso WB, et al. Modified Carbapenem Inactivation Method for Phenotypic Detection of Carbapenemase Production among Enterobacteriaceae. J Clin Microbiol. 2017;55(8):2321-2333. https://doi.org/10.1128/JCM.00193-17
CLSI. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. CLSI supplement M100. 36th ed. Wayne (PA), ABD: CLSI; 2026. Erişim tarihi: 07.02.2026.
Simner PJ, Johnson JK, Brasso WB, Anderson K, Lonsway DR, Pierce VM, et al. Multicenter Evaluation of the Modified Carbapenem Inactivation Method and the Carba NP for Detection of Carbapenemase-Producing Pseudomonas aeruginosa and Acinetobacter baumannii. J Clin Microbiol 2017;56(1): e01369-17. https://doi.org/10.1128/JCM.01369-17
Jing X, Zhou H, Min X, Zhang X, Yang Q, Du S, et al. The Simplified Carbapenem Inactivation Method (sCIM) for Simple and Accurate Detection of Carbapenemase-Producing Gram-Negative Bacilli. Front Microbiol. 2018;9: 2391. https://doi.org/10.3389/fmicb.2018.02391
Zhang S, Mi P, Wang J, Li P, Luo K, Liu S, et al. The optimized carbapenem inactivation method for objective and accurate detection of carbapenemase-producing Acinetobacter baumannii. Front Microbiol. 2023;14:1185450. https://doi.org/10.3389/fmicb.2023.1185450
Tsai YM, Wang S, Chiu HC, Kao CY, Wen LL. Combination of modified carbapenem inactivation method (mCIM) and EDTA-CIM (eCIM) for phenotypic detection of carbapenemase-producing Enterobacteriaceae. BMC Microbiol. 2020 Oct 17;20(1):315. https://doi.org/10.1186/s12866-020-02010-3
Baeza LL, Pfennigwerth N, Greissl C, Göttig S, Saleh A, Stelzer Y, et al. Comparison of five methods for detection of carbapenemases in Enterobacterales with proposal of a new algorithm. Clin Microbiol Infect. 2019; 25(10):1286.e9-1286.e15. https://doi.org/10.1016/j.cmi.2019.03.003
Meier M, Hamprecht A. Systematic Comparison of Four Methods for Detection of Carbapenemase-Producing Enterobacterales Directly from Blood Cultures. J Clin Microbiol. 2019;57(11):e00709-19. https://doi.org/10.1128/JCM.00709-19
Suriya R V, Kv L, Feliciana J H, R A. Diagnostic Test Precision of Modified Carbapenem Inactivation Method and Carbapenemase Nordmann-Poirel Test for Phenotypic Detection of Carbapenemase Production in Enterobacterales: A Systematic Review. Cureus. 2024;16(8):e67322. https://doi.org/10.7759/cureus.67322
Verma G, Singh N, Smriti S, Panda SS, Pattnaile D, Tripathy S, et al. Modified Carbapenem Inactivation Method and Ethylenediaminetetraacetic Acid (EDTA)-Carbapenem Inactivation Method for Detection of Carbapenemase-Producing Enterobacterales and Pseudomonas aeruginosa. Cureus. 2024;16(6):e63340. https://doi.org/10.7759/cureus.63340
