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"Simplified carbapenem inactivation method (sCIM) as a reliable tool for detecting OXA-48-producing enterobacterales in clinical practice"

Journal
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology (Q1)
Published
29 July 2026
Study design
Unclassified
Evidence level
Level 5, Expert Opinion (CEBM 5)
Authors
Ana Collazos-Blanco, Ana Belén García-Sáez, Inés-María Marcos-Palomino, Carolina Plaza-Cristobal, María Isabel Zamora-Cintas, María Simón-Sacristán, et al.
PMID
42525316
DOI
10.1007/s10096-026-05611-4

Why clinicians should know about it

Abstract

PURPOSE: Carbapenemase-producing Enterobacterales (CPE), particularly OXA-48-producing Enterobacterales, represent a major diagnostic and therapeutic challenge due to their frequent low-level carbapenem resistance and delayed microbiological detection. Rapid confirmation of carbapenemase production is essential to optimize antimicrobial therapy and infection control measures. METHODS: This study evaluated the simplified carbapenem inactivation method (sCIM) for detection of OXA-48-producing Enterobacterales. Unlike the conventional mCIM, sCIM eliminates the preliminary carbapenem inactivation incubation step, simplifying the workflow and reducing turnaround time. A total of 150 OXA-48-producing Enterobacterales were analyzed, together with additional VIM-, KPC-producing, and non-carbapenemase-producing isolates collected from clinical specimens at the Hospital Central de la Defensa "Gómez-Ulla" in Spain. Carbapenemase production was confirmed using the Xpert® Carba-R molecular assay. RESULTS: The sCIM detected all OXA-48-producing Enterobacterales with 100% sensitivity (95% CI: 97.6-100%) and no indeterminate results, including isolates with low ertapenem MICs. Results were available after 16-18 h of incubation without previous 4-hour carbapenem inactivation step, simplifying laboratory workflow compared with the conventional mCIM. CONCLUSIONS: The rapid detection of OXA-48-producing Enterobacterales remains a major diagnostic challenge due to their frequently low carbapenem MICs and subtle phenotypic expression. This study demonstrates that sCIM provides a simple, reliable, and highly sensitive method for detecting these isolates, even in cases with borderline susceptibility profiles. Given its low cost and ease of implementation, sCIM represents a valuable tool for routine clinical laboratories, particularly in high-prevalence or resource-limited settings.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.