Detection of carbapenemase production in Enterobacterales by mCIM and eCIM: a tertiary care hospital study

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 (...

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Main Authors: Touseefa Shafi, Anjum Ara Mir, Shagufta Roohi, Bashir Fomda, Sanam Rasool Wani, Tufail Ahmed, Samiah Yousuf
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2025-07-01
Series:Iranian Journal of Microbiology
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Online Access:https://ijm.tums.ac.ir/index.php/ijm/article/view/4966
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author Touseefa Shafi
Anjum Ara Mir
Shagufta Roohi
Bashir Fomda
Sanam Rasool Wani
Tufail Ahmed
Samiah Yousuf
author_facet Touseefa Shafi
Anjum Ara Mir
Shagufta Roohi
Bashir Fomda
Sanam Rasool Wani
Tufail Ahmed
Samiah Yousuf
author_sort Touseefa Shafi
collection DOAJ
description 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.
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institution Kabale University
issn 2008-3289
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publishDate 2025-07-01
publisher Tehran University of Medical Sciences
record_format Article
series Iranian Journal of Microbiology
spelling doaj-art-e33f95e205434474912c7503b5ac72bf2025-08-20T03:41:22ZengTehran University of Medical SciencesIranian Journal of Microbiology2008-32892008-44472025-07-0117410.18502/ijm.v17i4.19227Detection of carbapenemase production in Enterobacterales by mCIM and eCIM: a tertiary care hospital studyTouseefa Shafi0Anjum Ara Mir1Shagufta Roohi2Bashir Fomda3Sanam Rasool Wani4Tufail Ahmed5Samiah Yousuf6Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Jammu & Kashmir, IndiaDepartment of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Jammu & Kashmir, IndiaDepartment of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Jammu & Kashmir, IndiaDepartment of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Jammu & Kashmir, IndiaDepartment of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Jammu & Kashmir, IndiaDepartment of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Jammu & Kashmir, IndiaDepartment of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Jammu & Kashmir, IndiaBackground 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. https://ijm.tums.ac.ir/index.php/ijm/article/view/4966Carbapenem antibioticsCarbapenemasesBeta-lactamasesMetallo-beta-lactamaseMicrobial sensitivity tests
spellingShingle Touseefa Shafi
Anjum Ara Mir
Shagufta Roohi
Bashir Fomda
Sanam Rasool Wani
Tufail Ahmed
Samiah Yousuf
Detection of carbapenemase production in Enterobacterales by mCIM and eCIM: a tertiary care hospital study
Iranian Journal of Microbiology
Carbapenem antibiotics
Carbapenemases
Beta-lactamases
Metallo-beta-lactamase
Microbial sensitivity tests
title Detection of carbapenemase production in Enterobacterales by mCIM and eCIM: a tertiary care hospital study
title_full Detection of carbapenemase production in Enterobacterales by mCIM and eCIM: a tertiary care hospital study
title_fullStr Detection of carbapenemase production in Enterobacterales by mCIM and eCIM: a tertiary care hospital study
title_full_unstemmed Detection of carbapenemase production in Enterobacterales by mCIM and eCIM: a tertiary care hospital study
title_short Detection of carbapenemase production in Enterobacterales by mCIM and eCIM: a tertiary care hospital study
title_sort detection of carbapenemase production in enterobacterales by mcim and ecim a tertiary care hospital study
topic Carbapenem antibiotics
Carbapenemases
Beta-lactamases
Metallo-beta-lactamase
Microbial sensitivity tests
url https://ijm.tums.ac.ir/index.php/ijm/article/view/4966
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