Susceptibility to carbapenems. Medical search. Frequent questions

To achieve a diversity of β-lactam resistance phenotypes, we selected 15 isolates of K. pneumoniae from 4 hospitals in New York City, all serviced by a central microbiology laboratory, on the basis of varying susceptibility patterns to imipenem, meropenem, and extended-spectrum cephalosporins. (cdc.gov)
Its scarcity in the medical literature and resistance to numerous broad-spectrum antibiotics such as carbapenems, cephalosporins, and beta-lactam/lactamase inhibitors pose a diagnostic and therapeutic challenge. (hindawi.com)
Serious concurrent conditions and prior use of fluoroquinolones, carbapenems, or broad-spectrum cephalosporins have been independently associated with acquisition of infections caused by CRE. (cdc.gov)
The isolates were completely resistant to the second- and third-generation cephalosporins tested as well as carbapenems. (who.int)

KPC enzymes are among the most common β-lactamases mediating carbapenem resistance among isolates of Enterobacteriaceae ( 1 - 6 ). (cdc.gov)

Detecting β-lactamase-mediated carbapenem resistance among Klebsiella pneumoniae isolates and other Enterobacteriaceae is an emerging problem. (cdc.gov)
Carbapenem resistance among the Enterobacteriaceae is emerging in the United States, particularly on the East Coast ( 1 - 6 ). (cdc.gov)
In this work, we studied the antimicrobial resistance and performed a comparative genomics analysis of ten CR- Kp isolates from the Chilean surveillance of carbapenem-resistant Enterobacteriaceae . (biorxiv.org)
Carbapenems are last-resort antibiotics for treating severe infections caused by MDR Enterobacteriaceae [ 3 ]. (biorxiv.org)
During January--June 2010, three Enterobacteriaceae isolates carrying a newly described resistance mechanism, the New Delhi metallo-beta-lactamase (NDM-1) ( 1 ), were identified from three U.S. states at the CDC antimicrobial susceptibility laboratory. (cdc.gov)
Current CDC infection control guidance for carbapenem-resistant Enterobacteriaceae also is appropriate for NDM-1--producing isolates ( 5 ). (cdc.gov)
This includes recognizing carbapenem-resistant Enterobacteriaceae when cultured from clinical specimens, placing patients colonized or infected with these isolates in contact precautions, and in some circumstances, conducting point prevalence surveys or active-surveillance testing among other high-risk patients. (cdc.gov)
Clinicians should be aware of the possibility of NDM-1--producing Enterobacteriaceae in patients who have received medical care in India and Pakistan, and should specifically inquire about this risk factor when carbapenem-resistant Enterobacteriaceae are identified. (cdc.gov)
Infection control interventions aimed at preventing transmission, as outlined in current guidance ( 5 ), should be implemented when NDM-1--producing isolates are identified, even in areas where other carbapenem-resistance mechanisms are common among Enterobacteriaceae . (cdc.gov)
Guidance for control of infections with carbapenem-resistant or carbapenemase-producing Enterobacteriaceae in acute care facilities. (cdc.gov)
The intestine is the primary colonisation site for carbapenem-resistant Enterobacteriaceae (CRE) and serves as a reservoir of CRE that cause invasive infections (e.g. bloodstream infections). (imperial.ac.uk)
Carbapenem-resistant strains have emerged among species belonging to the Enterobacteriaceae family. (cdc.gov)
Several outbreaks caused by carbapenem-resistant Enterobacteriaceae , or CRE, have been recorded in health care facilities around the world, and in some places, CRE have become endemic. (cdc.gov)
Carbapenem resistance among Enterobacteriaceae has also increased. (ceufast.com)
Carbapenem-resistant Enterobacteriaceae (CRE) poses an increasing public health threat and has limited treatment options with high associated mortality. (kjcls.org)
In this study, we molecularly characterized 12 NDM-1 producing clinical Enterobacteriaceae ( Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae ) isolates that were part of a collection of non-carbapenem susceptible isolates obtained during a one-year period. (who.int)
Extended-spectrum beta-lactamase produc- ing Enterobacteriaceae was found in 37.5% (54) isolates and carbapenem resistant bacteria were identified in 27.8% of patients. (who.int)

When antibiotics are recently approved for use, it can take years before susceptibility tests for these antibiotics are made available in clinical labs. (cdc.gov)
MBLs make bacteria resistant to a broad range of antibiotics, including carbapenems, which are often used to treat antimicrobial-resistant infections. (cdc.gov)
Various types of β-lactam antibiotics, for example carbapenems, contain β-lactam rings in their structures and can be inactivated by β-lactamase enzymes. (frontiersin.org)
Apart from empirical treatment, the antibiotics used for treatment might be less effective against carbapenem-resistant infections as well. (cdc.gov)

Conclusion High number of resistant microorganisms was isolated, and increased mortality was documented from infections caused by carbapenem-resistant bacteria. (who.int)

Using the Hewlett-Packard D300e Digital Dispenser, highly resistant Enterobacterales isolates will be tested for susceptibility to the combination of aztreonam/avibactam. (cdc.gov)
Objectives: In this study we investigated the rate of susceptibility testing discrepancies between semi-automated and reference systems with carbapenem-resistant Enterobacterales (CRE) and the impact of alleged errors by semi-automated systems on guiding targeted therapy for CRE bloodstream infection (BSI). (unipd.it)
Enterobacterales isolates that are concomitant ESBL producers and are carbapenem resistant have been increasingly reported and demonstrate alarmingly increased antibiotic resistance patterns compared with ESBL Enterobacterales . (frontiersin.org)
At its forefront are Gram-negative bacteria, (GNB) such as Enterobacterales ( Enterobacterales ), Pseudomonas aeruginosa , and Acinetobacter baumannii , which have become increasingly resistant to most conventional and broad-spectrum antimicrobial agents, including carbapenems ( Nordmann and Poirel, 2019 ). (frontiersin.org)
Among individual countries, Enterobacterales and P. aeruginosa collected in Venezuela showed the greatest reductions in ceftazidime-avibactam susceptibility over time. (scielo.br)
In the present document, guidance is provided on the treatment of infections caused by extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E), AmpC β-lactamase-producing Enterobacterales (AmpC-E), carbapenem-resistant Enterobacterales (CRE), Pseudomonas aeruginosa with difficult-to-treat resistance (DTR-P. aeruginosa), carbapenem-resistant Acinetobacter baumannii species (CRAB), and Stenotrophomonas maltophilia. (idsociety.org)
Predicting phenotypic carbapenem resistance from WGS data overall showed 100% specificity but only 66.7% sensitivity for Enterobacterales isolates that were non-susceptible to imipenem and meropenem. (udayton.edu)
The importance of meropenem resistance, rather than imipenem resistance, in defining carbapenem-resistant Enterobacterales for public health surveillance: an analysis of national population-based surveillance. (bvsalud.org)
In Japan , carbapenem -resistant Enterobacterales (CRE) infections were incorporated into the National Epidemiological Surveillance of Infectious Diseases (NESID) in 2014, necessitating mandatory reporting of all CRE infections cases. (bvsalud.org)
A total of 71 CPGN bacilli (30 Enterobacterales and 41 non-glucose-fermenting bacilli) were tested for the carbapenemase production by the major phenotypic approaches including, the modified Hodge test (MHT), modified carbapenem inactivation method (mCIM), combined disk test by EDTA (CDT) and blue-carba test (BCT). (biomedcentral.com)

A total of 110 clinical isolates of A. baumannii , collected in a recent 2-year period, were tested for carbapenem antibiotic susceptibility, followed by a molecular analysis of carbapenemase genes. (frontiersin.org)
Regular antibiotic susceptibility surveillance in addition to antibiotic stewardship policy should be adopted. (ispub.com)
Antibiotic susceptibility testing was performed using the microdilution method (EUCAST). (ub.edu)

This approach is controversial ( 19 ) but has been adopted in slightly different forms by the European Committee on Antimicrobial Susceptibility Testing and the CLSI. (asm.org)

Escherichia coli and Klebsiella pneumoniae isolates were obtained from the Canadian Ward Surveillance Study (CANWARD) and underwent in vitro susceptibility testing to determine prevalence and antimicrobial resistance patterns. (umanitoba.ca)
Multidrug-resistant (MDR) and hypervirulent Klebsiella pneumoniae , particularly carbapenem-resistant strains (CR- Kp ) causing high mortality and morbidity, are critical concerns[ 1 ]. (biorxiv.org)
Carbapenem therapy for bacteremia due to extended-spectrum β-lactamase-producing Escherichia coli or Klebsiella pneumoniae. (nih.gov)
RÉSUMÉ L'émergence et la propagation rapide des souches de Klebsiella pneumoniae résistantes aux antibiotiques et porteuses du gène blaKPC codant la production de carbapénèmases ont compliqué la prise en charge des infections des patients. (who.int)
In Klebsiella pneumoniae (KP), modifications in the porin OmpK36 are implicated in increasing resistance to carbapenems. (imperial.ac.uk)
Detection of NDM-1 and VIM Genes in Carbapenem-Resistant Klebsiella pneumoniae Isolates from a Tertiary Health-Care Center in Kathmandu, Nepal. (tropmedres.ac)

Antibiotic sensitivity was performed by standard methods, and interpreted following both the old CLSI breakpoints (M100-S19) for carbapenems and the revised breakpoints (M100-S22). (who.int)
Antifungal susceptibility tested by broth microdilution following the most current CLSI interpretations. (wa.gov)
Antimicrobial susceptibility breakpoints from CLSI guidelines were used as standards to determine susceptibility against comparator agents, whereas tigecycline breakpoints were provided by the US Food and Drug Administration (FDA). (biomedcentral.com)

Our results show that the use of phenotypic methods is effective for the rapid detection of KPC producers in K. pneumoniae isolates with reduced susceptibility to carbapenems. (scielo.org.ar)
All K. pneumoniae isolates were processed for antimicrobial susceptibility testing (AST) using the disk diffusion method. (tropmedres.ac)
Methods Six hundred and forty-seven K. pneumoniae isolates (2008-2017) with reduced susceptibility to carbapenems were screened for blaBKC-1. (cardiff.ac.uk)

METHODS: Antimicrobial susceptibility testing was performed by reference broth microdilution. (imperial.ac.uk)
Susceptibility profiles were determined by broth microdilution, and additional antimicrobial resistance genes (ARGs) were investigated by polymerase chain reaction. (cardiff.ac.uk)

Predictive values for susceptibility and resistance were estimated as a function of susceptibility prevalence and were based on the absence or presence of beta-lactamase (bla) NDM, VIM, IMP, KPC, and OXA carbapenemase genes (e.g., bla OXA-23 , bla OXA-24/40 , and bla OXA-58 found in this study) against the reference standard of MIC determinations. (elsevierpure.com)
The most concerning carbapenem resistance mechanism corresponds to carbapenem-inactivating beta-lactamases, especially the K. pneumoniae carbapenemase (KPC) distributed worldwide, showing the highest prevalence. (biorxiv.org)
Carbapenem resistance and carbapenemase production conferred by bla NDM-1 is detected reliably with phenotypic testing methods currently recommended by the Clinical and Laboratory Standards Institute ( 3 ), including disk diffusion testing and the modified Hodge test ( 4 ). (cdc.gov)
Carbapenemases are a class of enzymes that can confer resistance to carbapenems and other Beta-lactam antibiotic drugs, but not all carbapenemase-producing isolates are carbapenem-resistant. (cdc.gov)
Overall, AST detected 60.34% (35/58) carbapenem-resistant isolates, while the MHT phenotypically confirmed 51.72% (30/58) isolates as carbapenemase-producers and 48.28% (28/58) as carbapenemase nonproducers. (tropmedres.ac)
Does the presence of multiple β-lactamases in Gram-negative bacilli impact the results of antimicrobial susceptibility tests and extended-spectrum β-lactamase and carbapenemase confirmation methods? (udayton.edu)
The aim of this study was to assess the impact of multiple β-lactamase carriage on the accuracy of susceptibility tests and extended-spectrum β-lactamase (ESBL) and carbapenemase confirmation methods. (udayton.edu)

The vast majority of NFGNB respond to broad-spectrum antibiotic regimens, such as beta-lactam/lactamase inhibitor combinations, cefepime, aminoglycosides, or carbapenems [ 4 ]. (hindawi.com)

Perform culture and antimicrobial susceptibility testing when clinically indicated. (cdc.gov)
Providers should consider performing culture and antimicrobial susceptibility testing to help guide therapy if patients report use of this product. (cdc.gov)
If necessary, the microbiologist gives training in basic microbiology to ICC and antimicrobial stewardship members and provides expertise (e.g., quality of preanalytical phase, interpretation of culture and antimicrobial susceptibility results, ready to use microbiological strategies to deal with each specific infection control situation, evaluation of resources needed). (isid.org)

The recognition of carbapenem-resistant K. pneumoniae continues to challenge automated susceptibility systems. (cdc.gov)
The widespread dissemination of carbapenem-resistant Acinetobacter spp. (elsevierpure.com)
According to the interpretation of MICs, 49% (n = 98) of the isolates were carbapenem resistant (as defined by either resistance or intermediate resistance to imipenem). (elsevierpure.com)
Multidrug and carbapenem-resistant K. pneumoniae (CR- Kp ) are considered critical threats to global health and key traffickers of resistance genes to other pathogens. (biorxiv.org)
Carbapenem-resistant Acinetobacter baumannii (CRAB) presents a serious therapeutic and infection control challenge. (frontiersin.org)
Sixty-seven of the 110 isolates (60.9%) were resistant to carbapenems, 80.60% (54/67) of which carried the bla OXA-23 gene. (frontiersin.org)
CDC asks that carbapenem-resistant isolates from patients who have received medical care within 6 months in India or Pakistan be forwarded through state public health laboratories to CDC for further characterization. (cdc.gov)
Antimicrobial susceptibility profile showed that the majority of the isolates were sensitive to Imipenem and Nitrofurantoin while most were significantly resistant to, augmentin, ampicillin, cotrimoxazole, gentamicin, cefuroxime, cefotaxime, and ceftazidime. (ispub.com)
These nutrients also increase in faeces from antibiotic-treated mice and decrease following intestinal colonisation with carbapenem-resistant Escherichia coli. (imperial.ac.uk)
bla CTX-M (subtype group 1) followed by/co-dominated by bla TEM and bla SHV , whereas the most common carbapenem-resistant genes are bla OXA-48 and bla NDM-1 . (frontiersin.org)
ESBL producers are usually multiply drug resistant ( 5 , 30 ), but their cephalosporin and aztreonam resistance is not reliably detected by susceptibility tests ( 33 ). (asm.org)
Carbapenems are used as the last resort for the treatment of multidrug resistant Gram-negative bacterial infections. (tropmedres.ac)
The main objective of this study was to detect the carbapenem-resistant genes blaNDM-1 and blaVIM in K. pneumoniae isolated from different clinical specimens.MethodsA total of 585 clinical specimens (urine, pus, sputum, blood, catheter tips, and others) from human subjects attended at Annapurna Neurological Institute and Allied Sciences, Kathmandu were obtained in the period between July 2018 and January 2019. (tropmedres.ac)
In the same assay among 28 carbapenem nonproducing isolates, 9 (32.14%) isolates were positive for blaNDM-1 gene while none of them were tested positive for blaVIM gene.ConclusionsMolecular detection of resistant genes provides greater specificity and sensitivity than those with conventional techniques, thus aiding in accurate identification of antimicrobial resistance and clinical management of the disease. (tropmedres.ac)
The work package focusing on molecular studies generated new evidence about the changes effected by antibiotic therapy on commensal organisms or opportunistic pathogens in the oropharyngeal, nasal and gastro-intestinal flora and study AMR mechanisms and the dissemination of successful clones of fluoroquinolone-resistant, carbapenem-resistant or extended-spectrum beta-lactamase harboring Gram-negative bacteria, MRSA and fluoroquinolone-resistant viridans streptococci. (europa.eu)
The aim of this study was to find the various risk factors leading to sepsis with carbapenem-resistant organisms (CRO) and also to analyse the various clinical outcomes among sepsis due to CRO. (jacmjournal.org)
Carbapenem-resistant sepsis was associated with increased mortality. (jacmjournal.org)
Colistin is the drug of choice for carbapenem-resistant sepsis. (jacmjournal.org)
[6] The Polymyxins along withTigecycline and Fosfomycin have become the last resort drugs in managing sepsis due to carbapenem-resistant organisms (CROs). (jacmjournal.org)
Owing to their broad spectrum of activity and stability towards the majority of β-lactamases, carbapenems are considered one of the last lines of therapy to treat severe infections caused by multi-drug resistant (MDR) bacteria [ 2 ]. (biomedcentral.com)
Age 65 years, presence of septic shock, and presence of carbapenem-resistant bacteria were independently associated with in- creased in-hospital mortality. (who.int)
Should mcr-1 be transferred to organisms that are already resistant to carbapenem, it would "seriously compromise treatment options not only in China but also globally," write Yang Wang, PhD, from the Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing, and colleagues in one of two studies published online January 27 in the Lancet Infectious Diseases . (medscape.com)
Many of the isolates also proved resistant to other drugs as well as colistin, although there was little evidence of extensive carbapenem coresistance. (medscape.com)
Of those, five of which were resistant to carbapenem as well as colistin: two from Guangdong and three from Zhejiang. (medscape.com)

Although increasing numbers of laboratories are now identifying P.penneri strains, the numbers reported in susceptibility studies are relatively small for a general assessment of the incidence of the species. (wikipedia.org)
We measure the nutrient utilisation abilities, nutrient preferences, and metabolite inhibition susceptibilities of several CRE strains. (imperial.ac.uk)
The simulation of combined disks by our pre-diffusion technique detected all KPCpositive strains for all 3 carbapenems when using boronic acid as inhibitor, clavulanic acid was less susceptible and specific as compared with boronic acid. (scielo.org.ar)
However, ESBL algorithms produced inconsistent results and predicting carbapenem resistance from WGS data was problematic in such strains. (udayton.edu)

Susceptibility results will be reported for ceftazidime/avibactam, aztreonam, and aztreonam/avibactam to help assess utility of combination therapy. (cdc.gov)
KPC-109 production mediated resistance/decreased susceptibility to avibactam-based combinations (with ceftazidime, cefepime and aztreonam) and cefiderocol, with a trade-off on carbapenem resistance. (imperial.ac.uk)

[2] The empiric antibiotic for Gram-negative sepsis is either carbapenems or Piperacillin-Tazobactam. (jacmjournal.org)

Resistance to the most widely used carbapenems, i.e., imipenem and meropenem, can be mediated by a variety of mechanisms, including β-lactamases, porin changes, and changes in penicillin-binding proteins ( 1 , 7 , 8 ). (cdc.gov)
Several recent proficiency testing studies have shown problems of both false resistance and false susceptibility with imipenem and meropenem among a variety of enteric species ( 11 , 12 ). (cdc.gov)

Only azithromycin, members of the carbapenem class, and tigecycline remain effective against XDR isolates. (medscape.com)
Susceptibility profiling of the isolates indicated that 100% retained susceptibility to tigecycline while 11/12 (91.7%) were susceptible to colistin. (who.int)

The resistance mechanism for CPE is attributed to the following Ambler molecular classes of carbapenem-hydrolysing beta-lactamases: class A (KPC), class B (IMP, NDM, VIM), and class D (OXA-48) [ 5 ]. (biomedcentral.com)

In this study, we report on the antimicrobial susceptibility of Gram-positive bacteria and Gram-negative bacteria isolated from blood specimen collected from around the world between 2012 and 2016. (biomedcentral.com)

All the isolates were susceptible to carbapenems and colistin. (medrxiv.org)
[7] By the time carbapenem resistance is detected and Colistin is administered, it may be life-threatening. (jacmjournal.org)

0.12 mg/L with immunochromatography, colorimetric tests, carbapenem inactivation, or carbapenem hydrolysis with MALDI-TOF). (ub.edu)

Informing antibiotic treatment decisions: Evaluating rapid molecular diagnostics to identify susceptibility and resistance to carbapenems against Acinetobacter spp. (elsevierpure.com)
Two RMD platforms, PCR combined with electrospray ionization mass spectrometry (PCR/ESI-MS) and molecular beacons (MB), for detecting genes conferring resistance/susceptibility to carbapenems in Acinetobacter spp. (elsevierpure.com)
PRIMERS III establishes that RMDs can discriminate between carbapenem resistance and susceptibility in Acinetobacter spp. (elsevierpure.com)

To determine the prevalence of UTIs, aetiological agents and antimicrobial susceptibility profile of the isolates among pregnant women attending antenatal clinics in some selected hospitals in Enugu. (ispub.com)
The high prevalence of co-resistance to betalactam, aminoglycoside and quinolone against PSA has necessitated increased use of carbapenems. (amrita.edu)

Isolates from patients linked to the outbreak in Pakistan are susceptible to carbapenems and azithromycin. (cdc.gov)
the subset of isolates that underwent antimicrobial susceptibility testing for cefiderocol were susceptible to this agent. (cdc.gov)

We evaluated phenotypic methods for the detection of KPC carbapenemases in 44 clinical isolates of K. pneumoniae having reduced susceptibility to carbapenems, 30 of which were KPC-positive and 14 KPC-negative. (scielo.org.ar)
The following phenotypic methods were assayed: the double disk synergy test, using boronic acid or clavulanic acid as inhibitors, "combined" disks of carbapenem plus inhibitor (boronic acid, clavulanic acid and both boronic plus clavulanic acid), by using a pre-diffusion technique and the modified Hodge test. (scielo.org.ar)

bacterial etiology, pregnant women, susceptibility profile. (ispub.com)
Those presumptively identified as N. gonorrhoeae by Gram stain and oxidase reaction will be shipped for bacterial identification and antimicrobial susceptibility testing. (wa.gov)

reported the dissemination of MDR OXA-23-producing A. baumannii clones throughout multiple cities in China, but little is known about the molecular mechanisms of resistance to carbapenems in western China. (frontiersin.org)
Because susceptibility tests may be unreliable, special tests are required to detect the resistance mechanisms involved. (asm.org)
MBL production among PSA is one of the several mechanisms causing carbapenem resistance (CARB-R) transferable by integrons. (amrita.edu)
Although brief descriptions of notable clinical trials, resistance mechanisms, and antimicrobial susceptibility testing (AST) methods are included, the document does not provide a comprehensive review of these topics. (idsociety.org)

Susceptibility testing of these specimens showed the same resistance pattern described in Pakistan. (cdc.gov)

Laboratory identification of the carbapenem- resistance mechanism is not necessary to guide treatment or infection control practices but should instead be used for surveillance and epidemiologic purposes. (cdc.gov)
Ongoing antimicrobial susceptibility testing and antibiotic prescription surveillance are critical for enhancing antimicrobial stewardship measures. (japsonline.com)

Clinicians should consider empiric treatment with a carbapenem, azithromycin, or both agents for suspected typhoid fever in patients who did not travel out of the United States and for those who traveled to Pakistan or Iraq. (cdc.gov)

Availability of iron increases host susceptibility to K pneumoniae infection. (medscape.com)
Condition of patient, severity of infection, and susceptibility of microorganism determines proper dose and route of administration. (medscape.com)

However, in the presence of porin alterations commonly encountered in high-risk clonal lineages of K. pneumoniae, KPC-109 was able to confer clinical-level resistance to carbapenems as well. (imperial.ac.uk)

We verified and whole genome-sequenced 68 bloodstream E. coli isolates recovered between 2016 and 2018 at three sentinel sites in southwestern Nigeria and susceptibility tested 67 of them. (medrxiv.org)
The NESID data between April 2017 and March 2018 were obtained and analyzed using antimicrobial susceptibility test results. (bvsalud.org)

Organisms24

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Chemicals and Drugs38

Analytical, Diagnostic and Therapeutic Techniques and Equipment18

Phenomena and Processes30

Disciplines and Occupations1

Anthropology, Education, Sociology and Social Phenomena1

Information Science4

Health Care10

Geographicals3

Cephalosporins4

Mediating carbapenem resistance1

Enterobacteriaceae17

Antibiotics4

Caused by carbapenem-resistant1

Enterobacterales10

Antibiotic susceptibility3

European Committee on Antimicrobial Susceptibility Testing1

Klebsiella6

CLSI3

Pneumoniae isolates3

Broth microdilution2

Carbapenemase7

Aminoglycosides1

Culture and antimicrobial susceptibility3

Resistant24

Strains4

Aztreonam2

Piperacillin-tazobactam1

Meropenem2

Tigecycline2

Beta-lactamases1

Bacteria1

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Inactivation1

Acinetobacter3

Prevalence2

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