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Background  Prompt identification of carbapenemase-harboring organisms is valuable in informing therapeutic and infection-control measures. The modified carbapenem inactivation method (mCIM) and EDTA-modified carbapenem inactivation method (eCIM) are inexpensive and easy to interpret phenotypic tests endorsed by the Clinical and Laboratory Standards Institute (CLSI) for the detection of carbapenemase-harboring Enterobacterales. Only mCIM is endorsed by CLSI for detecting carbapenemase-harboring  Pseudomonas aeruginosa . eCIM’s ability to delineate serine and metallo-β-lactamases (MBL) could be advantageous in areas prevalent with carbapenemase-harboring  P. aeruginosa . A recent assessment of mCIM/eCIM on MBL-harboring  P. aeruginosa  demonstrated high eCIM sensitivity for NDMs and VIMs but not for IMP-producers. Therefore, this study aimed to determine whether increasing EDTA concentrations would enhance eCIM sensitivity for a collection of IMP-harboring  P. aeruginosa  isolates .   Twenty-six IMP-harboring  P. aeruginosa  isolates were utilized. For test validation, additional  P. aeruginosa  isolates harboring NDM ( n  = 3), VIM (n = 3), KPC ( n  = 8), wild-type ( n  = 1), and Enterobacterales isolates harboring IMP ( n  = 6) and NDM (n = 1) were assessed. The mCIM test was conducted as outlined by CLSI. Simultaneously, the eCIM test was performed with the standard 5 mM EDTA concentration and doubling EDTA concentrations: 10 mM, 20 mM, and 40 mM.    Results  Concentration-dependent improvement was observed among the IMP-harboring  P. aeruginosa  with eCIM sensitivities at 0, 31, 85, and 100% respectively .  Remaining Enterobacterales and  P. aeruginosa  responded concordantly with their genotype at the standard 5 mM eCIM concentration, with doubling EDTA concentrations providing no greater sensitivity.    Conclusion  Combination of mCIM and an eCIM with a 40 mM EDTA concentration appropriately capture IMP-harboring  P. aeruginosa  without sacrificing test utility for other carbapenemase-harboring isolates.

bmc microbiology

EDTA-modified carbapenem inactivation method (eCIM) for detecting IMP Metallo-β-lactamase–producing Pseudomonas aeruginosa: an assessment of increasing EDTA concentrations