An upgraded version of carbapenem inactivation method to detect Bacteroides fragilis carbapenemase

Diagn Microbiol Infect Dis. 2023 Feb;105(2):115857. doi: 10.1016/j.diagmicrobio.2022.115857. Epub 2022 Nov 7.

Abstract

An increase of carbapenemase-producing Bacteroides fragilis infections is observed. To detect such a resistance in B. fragilis, several tests exist that are expensive or show poor sensitivity and specificity. Therefore, we upgraded the Anaerobic Carbapenem Inactivation Method (Ana-CIM) to easily screen for carbapenemase-producing B. fragilis. The presence of carbapenemase cfiA gene was identified in 50 B. fragilis isolates by PCR. We modified the Ana-CIM by (1) increasing the bacterial inoculum, and (2) measuring the differences in diameter between the negative control and the testing disc. We correctly classified the cfiA-negative and positive isolates and could define a cut-off of positivity at 2 mm. Our modified Ana-CIM allowed to correctly discriminate the 31 cfiA-positive with meropenem MICs ranging from 1 to > 32 µg/mL. We anticipate that our modified Ana-CIM could be used in most clinical laboratories to easily screen for carbapenemase-producing B. fragilis, even at low levels.

Keywords: Bacteroides fragilis; Carbapenem inactivation method; Carbapenemase; cfiA.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Bacterial Proteins* / genetics
  • Bacteroides fragilis* / enzymology
  • Bacteroides fragilis* / genetics
  • Carbapenems / pharmacology

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • carbapenemase
  • Carbapenems