Improving Carbapenem Resistance Identification: A Comprehensive Evaluation of bc-CIM in Positive Blood Cultures

Authors: Spandan M D, Dr Deepashree Rajshekar, Dr Sujatha S R, Nivedita Varma, Shalini Prasanna Kumar

DOI: 10.18231/j.ijmmtd.12473.1761393248

Keywords: Keywords: Drug resistance, Blood cultures, Carbapenem inactivation method, bc-CIM.

Abstract: Abstract Background: Early detection of drug resistance in blood culture positives is essential for effective clinical management. It enables timely and targeted antibiotic therapy, reduces the spread of resistant pathogens, and improves patient outcomes by decreasing mortality and morbidity. Additionally, early detection can help prevent ineffective treatments, leading to more efficient resource utilization and cost savings in healthcare. Overall, it plays a critical role in controlling the impact of drug-resistant infections. Aim & Objective: To know the prevalence of carbapenemases i.e serine and metallo beta lactamase-producing gram-negative bacterial pathogens isolated from blood culture and the Organism susceptibility profile of organisms isolated from blood culture. Materials and Methods The bcCIM test was employed to identify the production of carbapenemase among 100 positive blood cultures. Subcultures of positive blood cultures were done and mCIM test was done to all Gram-negative bacilli (GNB). The results were compared with the VITEK MIC results for each isolate. Results: A total of 100 Gram-negative bacteria (GNB) were isolated, with Klebsiella species being the most frequently identified, accounting for 55% (55 isolates). The majority of the isolated GNBs, 33 (60%), exhibited resistance to carbapenems. There was a strong agreement (kappa = 0.838) between the results of the m-CIM test and the bc-CIM test for all GNB isolates. Conclusion: Multidrug-resistant gram-negative organisms in sepsis require rapid pathogen identification with susceptibility profiling. This study proposes standardizing the blood culture carbapenem inactivation method (bc-CIM) for quicker, cost-effective carbapenemase detection, enhancing infection control, and targeted therapy. Implementing Direct susceptibility testing (DST) from positive blood cultures further reduces turnaround times, improving outcomes by enabling faster, appropriate treatment.