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. 2023 Jul 3;12(7):1146.
doi: 10.3390/antibiotics12071146.

Screening for Metallo-Beta-Lactamases Using Non-Carbapenem Agents: Effective Detection of MBL-Producing Enterobacterales and Differentiation of Carbapenem-Resistant Enterobacterales

Kentarou Takei  1 , Hajime Kanamori  1 , Asami Nakayama  2 , Mikiko Chiba  2 , Yumiko Takei  1 , Issei Seike  1 , Chiho Kitamura  1 , Hiroaki Baba  1 , Kengo Oshima  1 , Koichi Tokuda  1
Affiliations

Screening for Metallo-Beta-Lactamases Using Non-Carbapenem Agents: Effective Detection of MBL-Producing Enterobacterales and Differentiation of Carbapenem-Resistant Enterobacterales

Kentarou Takei et al. Antibiotics (Basel). .

Abstract

Metallo-beta-lactamases (MBLs) are enzymes that break down carbapenem antibiotics, leading to carbapenem-resistant organisms. Carbapenemase-resistant Enterobacterales (CRE) is one of them. Outbreaks of CRE infection can occur in healthcare facilities and lead to increased deaths, illness, and medical costs. This study was conducted to detect MBLs using non-carbapenem agents and exclude MBLs among CRE isolates. A total of 3776 non-duplicate sequential Enterobacterales isolates from a single facility were screened between January 2019 and December 2022 using non-carbapenem agents, ceftazidime and cefoperazone/sulbactam. Positive 153 isolates (4.0%) were further tested using carbapenemase-confirmation tests and verified through polymerase chain reaction (PCR) testing. Fifteen imipenemase (IMP)-type MBL-producing Enterobacterales (0.4%) including one susceptible to carbapenems were identified. Moreover, 160 isolates (4.2%) meeting the criteria for CRE were directly subjected to PCR testing. All fourteen CRE isolates with MBLs identified through PCR testing were found to be the same strains screened using ceftazidime and cefoperazone/sulbactam. Screening using ceftazidime and cefoperazone/sulbactam can effectively detect MBL-producing Enterobacterales strains. This screening method showed comparable results to screening with meropenem, potentially serving as a supplementary approach and contributing to differentiating between MBL- and non-MBL-producing CRE strains. Our findings support these screening methods, particularly in regions where IMP-type MBLs are prevalent.

Keywords: carbapenem-resistant Enterobacterales; cefoperazone/sulbactam; ceftazidime; metallo-β-lactamase.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Identification and exclusion process for isolates screened using ceftazidime and cefoperazone/sulbactam, based on the definition of carbapenem-resistant Enterobacterales. Abbreviations: IMP, imipenemase; SMA, sodium mercaptoacetic acid; MIC, minimum inhibitory concentration.
See this image and copyright information in PMC

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