Improved performance of the modified Hodge test with MacConkey agar for screening carbapenemase-producing Gram-negative bacilli

The detection of carbapenemases in Gram-negative bacilli is important for optimal patient treatment and to control spread of the resistance. The modified Hodge test can detect carbapenemase-producing Gram-negative bacilli. In this study, we compared the performance of MacConkey agar and Mueller-Hinton agar for metallo-β-lactamase (MBL) and OXA carbapenemase screening. Overall, the performance of Hodge test was better with MacConkey agar due to enhanced release of β-lactamases from the cells in the presence of bile compounds. Concomitant use of the modified Hodge test could resolve most of the problems with uncertain double-disk synergy tests in MBL detection.