الفهرس 
CARBAPENEM-RESISTANT GRAM-NEGATIVE BACILLIOnly 14 pages are availabe for public view
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Abstract
Early detection of BSIs caused by carbapenemase-producing organisms can guide rapid life-saving appropriate therapy. A new variant of the modified Carbapenem Inactivation Method (mCIM) test, named blood culture CIM (bcCIM), can directly detect carbapenemase enzymes from positive blood culture.
This study aimed at comparing detection of carbapenemase activity in GNB by carbapenem inactivation method on positive blood culture and isolated colonies.
bcCIM test was used to detect carbapenemase production in 38 positive blood cultures. Subculture of blood samples followed by isolation and identification of causative pathogens was done, antimicrobial susceptibility by disc diffusion test as well as performing mCIM test were applied to all isolated GNB.
Forty-one GNB were isolated. Klebsiella spp. was the most common isolated GNB 16 (39%). Most isolated GNB were carbapenem-resistant 31(75.6%). For mono-microbial BSIs, there was fair (kappa =0.327), moderate (kappa=0.429), and slight agreement (kappa=0.158) between
results of mCIM and results of bcCIM as regards all GNB, Enterobacteriaceae, and Pseudomonas, respectively.
The sensitivity and specificity of bcCIM in detecting carbapenemase-producing GNB were 58.6% and 100% respectively. In carbapenemase-producing Enterobacteriaceae, sensitivity and specificity were 60% and 100% respectively while in case of carbapenemase-producing Pseudomonas spp., they were 42.9% and 100%. In the case of Acinetobacter baumannii, the bcCIM test was able to detect 5 out of 7 (71.4%), positive carbapenemase producers, by mCIM.