{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T13:10:47Z","timestamp":1788959447866,"version":"build-2803163510"},"reference-count":38,"publisher":"American Society for Microbiology","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"CIBERES-Centro de Investigaci\u00f3n Biom\u00e9dica en Red. Enfermedades Respiratorias","award":["CB06\/06\/0058"],"award-info":[{"award-number":["CB06\/06\/0058"]}]},{"name":"CIBER -Consorcio Centro de Investigaci\u00f3n Biom\u00e9dica en Red","award":["CB21\/13\/00068"],"award-info":[{"award-number":["CB21\/13\/00068"]}]},{"name":"CIBER -Consorcio Centro de Investigaci\u00f3n Biom\u00e9dica en Red","award":["CB21\/13\/00084"],"award-info":[{"award-number":["CB21\/13\/00084"]}]},{"name":"CIBER -Consorcio Centro de Investigaci\u00f3n Biom\u00e9dica en Red","award":["CB21\/13\/00095"],"award-info":[{"award-number":["CB21\/13\/00095"]}]},{"name":"CIBER -Consorcio Centro de Investigaci\u00f3n Biom\u00e9dica en Red","award":["CB21\/1300049"],"award-info":[{"award-number":["CB21\/1300049"]}]},{"name":"Study Group on Mechanisms of Action and Resistance to Antimicrobials","award":["GEMARA-2023 Research Project"],"award-info":[{"award-number":["GEMARA-2023 Research Project"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2026,9,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Detection of GES-type carbapenemases remains challenging because of their low prevalence and frequently weak hydrolytic activity against carbapenems. Carbapenem inactivation method (CIM)-based assays are widely used as phenotypic screening tools for carbapenemase detection; however, their performance in large collections of GES producers has not been systematically evaluated. We assessed the performance of CIM, modified CIM (mCIM), and CIM-Tris in a diverse collection of GES-producing clinical isolates, including 110 Enterobacterales and 108\n                      <jats:italic toggle=\"yes\">Pseudomonas aeruginosa,<\/jats:italic>\n                      recovered from Spanish hospitals (2010\u20132024), and 10\n                      <jats:italic toggle=\"yes\">Acinetobacter baumannii<\/jats:italic>\n                      isolates, mostly obtained from a hospital in Egypt. Whole-genome sequencing was carried out for species confirmation and resistome analysis. Meropenem MICs were determined by broth microdilution. Overall, 92.1% of isolates were GES-carbapenemase producers (CP), whereas 7.9% expressed GES-type extended-spectrum \u03b2-lactamases (ESBLs). In Enterobacterales (predominantly carrying\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>GES-6<\/jats:sub>\n                      ), mCIM improved sensitivity compared with CIM (63.6% vs 40.0%), although many isolates remained undetected due to low meropenem MICs (MIC\n                      <jats:sub>50<\/jats:sub>\n                      , 0.5 \u00b5g\/mL). In CP-\n                      <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                      (mainly\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>GES-5<\/jats:sub>\n                      ), CIM, mCIM, and CIM-Tris showed sensitivities of 89.1%, 94.6%, and 100%, respectively; however, CIM-Tris yielded false-positive results in 50% of non-CP isolates (mostly\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>GES-1<\/jats:sub>\n                      producers). Meropenem MICs in\n                      <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                      were higher (MIC\n                      <jats:sub>50<\/jats:sub>\n                      , &gt;32 \u00b5g\/mL). In\n                      <jats:italic toggle=\"yes\">A. baumannii<\/jats:italic>\n                      , CIM-Tris improved sensitivity compared with CIM (100% vs 25.0%). These findings indicate that CIM-based methods can detect GES-type carbapenemases, but performance varies according to bacterial species and GES variant, and reduced specificity may occur in isolates producing GES-type ESBLs. Complementary molecular testing may therefore be necessary to ensure accurate detection of GES-type carbapenemases in routine clinical laboratories.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>\n                      GES-type carbapenemases represent an important but underrecognized diagnostic challenge due to their low global prevalence, heterogeneous hydrolytic activity, and the limited performance data available for routine phenotypic detection methods. Although CIM-based assays are widely implemented in clinical microbiology laboratories for carbapenemase screening, their performance against GES-producing organisms has not been comprehensively evaluated across different bacterial genera and GES variants. In this study, we evaluated the performance of CIM, modified CIM (mCIM), and CIM-Tris in a large multicenter collection of well-characterized GES-producing clinical isolates, including Enterobacterales,\n                      <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>\n                      , and\n                      <jats:italic toggle=\"yes\">Acinetobacter baumannii<\/jats:italic>\n                      . Our findings demonstrate substantial variability in assay performance according to bacterial species and GES variant. Notably, mCIM improved sensitivity among Enterobacterales with low meropenem MICs, whereas CIM-Tris achieved excellent sensitivity in\n                      <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">A. baumannii<\/jats:italic>\n                      but at the expense of reduced specificity in isolates producing GES-type ESBLs. To the best of our knowledge, this is the first study directly comparing multiple CIM-based approaches in such a large and taxonomically diverse collection of GES-producing isolates.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/jcm.00737-26","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:00:38Z","timestamp":1787310038000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of carbapenem inactivation method-based phenotypic assays for the detection of GES-type carbapenemases in Enterobacterales,\n                    <i>Pseudomonas aeruginosa<\/i>\n                    , and\n                    <i>Acinetobacter baumannii<\/i>"],"prefix":"10.1128","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2950-4536","authenticated-orcid":true,"given":"Samuel","family":"Garc\u00eda-Garc\u00eda","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01w4yqf75","id-type":"ROR","asserted-by":"publisher"}],"name":"Servicio de Microbiolog\u00eda, Hospital Universitario Marqu\u00e9s de Valdecilla \u2013 IDIVAL","place":["Santander, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8229-6049","authenticated-orcid":true,"given":"Jorge","family":"Rodr\u00edguez-Grande","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01w4yqf75","id-type":"ROR","asserted-by":"publisher"}],"name":"Servicio de Microbiolog\u00eda, Hospital Universitario Marqu\u00e9s de Valdecilla \u2013 IDIVAL","place":["Santander, Spain"]},{"id":[{"id":"https:\/\/ror.org\/00ca2c886","id-type":"ROR","asserted-by":"publisher"}],"name":"CIBER de 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