Accurate detection of carbapenemase-producing Gram-negative bacilli is of utmost importance for the control of nosocomial spread and the initiation of appropriate antimicrobial therapy. The modified Hodge test (MHT), a carbapenem inactivation assay, has shown poor sensitivity in detecting the worldwide spread of New Delhi metallo-β-lactamase (NDM). Recent studies demonstrated that NDM is a lipo...

The global spread of class A-carbapenemase-producing Enterobacteriaceae has made the development of a simple test a desirable goal. A disc diffusion test using imipenem was 100% sensitive and 96% specific in identifying carbapenemase-producing organisms, potentially reducing or eliminating the need for the relatively labor-intensive modified Hodge test.

Introduction: Acinetobacter baumannii, a known causative agent of nosocomial infections, is one of the highly antibiotic-resistant gram-negative bacilli. Carbapenem-resistant Acinetobacter isolates are increasingly reported worldwide. Carbapenems such as imipenem and meropenem are efficient antimicrobial agents commonly used for the treatment of infections caused by multi- resistant A. baumanni...

The modified Hodge test has an excellent sensitivity for detecting enterobacterial isolates producing Ambler class A (KPC) and class D (OXA-48) carbapenemases. Its sensitivity is low for NDM-1 producers (50%) but is increased to 85.7% by adding ZnSO(4) (100 μg/ml) in the culture medium. However, this test has a low specificity and is time-consuming.

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Mustafa Hatipoglu, Sevket Balta, Mustafa Cakar, Sait Demirkol, Omer Kurt, Mustafa Dinc I Gulhane Military Medicine Academy Haydarpasa Training Hospital, Infectious Diseases and Clinical Microbiology, Üsküdar/İstanbul, Turkey. II Gulhane Medical Academy, Cardiology, Ankara, Turkey. III Gulhane Medical Academy, Internal Medicine, Ankara, Turkey. IV Beytepe Military Hospital, Internal Medicine, An...