Detection of carbapenem-resistant gram-negative bacilli in Japan using the fully automated bacterial testing device RAISUS S4

Abstract

Objective: We investigated a rapid detection method for carbapenemase-producing gram-negative bacilli (CP-GNR) using meropenem (MEPM) to assess the efficiency of the antimicrobial susceptibility testing.

Methods: We used the function that can monitor the growth curve with the resistant bacteria monitoring function (RAISUS S4). Rapid detection of CP-GNR was performed using RAISUS S4 in two types of antimicrobial susceptibility testing, the RAISUS 18-hour method (18-h method) and RAISUS rapid method (rapid method) for Enterobacterales (F-GNR) and non-fermenting gram-negative bacilli (NF-GNR).

Results: When F-GNR were based on MEPM MIC ≥ 0.25 µg/mL, CP-GNR were detected with a sensitivity of 100% (58/58) for the 18-h method and 98.3% (57/58) for the rapid method; the shortest detection times were 5.3 and 4.0 h, respectively. When NF-GNR were based on MEPM MIC > 8 µg/mL, it was possible to detect CP-GNR with 100% sensitivity (58/58) in both methods. Furthermore, in the analysis using the 18-h method for monitoring resistant bacteria, when ≥ 2 µg/mL was used as the screening concentration for F-GNR, approximately 50% of the resistant genotypes, NDM, GES, and KPC, were detected in approximately 7 h However, detecting the IMP and VIM took 11-12 h CONCLUSIONS: The 18-h and rapid methods with RAISUS S4 were highly correlated with the results of the microdilution method of CLSI, and CP-GNR detection was rapid using a function that can monitor the growth curve with RAISUS S4.

Keywords: Antimicrobial susceptibility testing; Carbapenem-resistant non-fermenting gram-negative bacilli; Carbapenemase-producing enterobacterales; IMP; RAISUS S4.