The Evolving Threat of ESBL, AmpC, and KPC -lactamases - SWACM
The Evolving Threat of ESBL, AmpC, and KPC -lactamases - SWACM The Evolving Threat of ESBL, AmpC, and KPC -lactamases - SWACM
2010 Breakpoints: Are they sufficient? • MIC 2 µg/ml: cefepime failure, meropenem cure • MIC 0.5 µg/ml: cefepime + gent 5 days, died Paterson et al 2001 J Clin Microbiol 39:2206-2212 • MIC 4 µg/ml: cefepime failure Bhavnani 2006 Diagn Microbiol Infect Dis 54:231-236 • MIC 0.75 µg/ml: cefotaxime failure, cured with ciprofloxacin Karas et al 1996 J Antimicrob Chemother 37:203-204
Inoculum Effect: Are Cephalosporin MICs Accurate E. coli Microdilution MIC in µg/ml Enzyme Inoculum Cefotaxime Cefepime Imipenem SHV-3 5 x 10 5 8 2 0.06 SHV-3 5 x 10 7 1024 1024 0.5 19
- Page 1: The Evolving Threat of ESBL, AmpC,
- Page 4 and 5: Normal Gram-negative
- Page 6 and 7: ß-lactamases O CH 2 C NH O N S CH
- Page 8 and 9: Old Plasmid-Encoded ß-lactamases T
- Page 10 and 11: 3 rd Generation Cephalosporins Cefo
- Page 12 and 13: Evolution of ESBLs TEM-3, 4 ......
- Page 14 and 15: ESBL-producing Organisms Most Commo
- Page 16 and 17: CLSI 2010 (M100-S20) • If laborat
- Page 20: Inoculum Effect: In Vitro Artifact?
- Page 23 and 24: -lactams Still Active Carbapenems C
- Page 25 and 26: AmpC-mediated Resistance Resistant
- Page 27 and 28: Plasmid-mediated AmpCs • Klebsiel
- Page 29 and 30: Clinical Significance of AmpC for K
- Page 31 and 32: Klebsiella pneumoniae 225 Resistant
- Page 34 and 35: Carbapenemases Class A (KPC, GES, S
- Page 36 and 37: Miami KPC Outbreak • Admission fi
- Page 38 and 39: Which MIC do we use? Carbapenem MIC
- Page 41: Thanks for your attention!
Inoculum Effect:<br />
Are Cephalosporin MICs Accurate<br />
E. coli Microdilution MIC in µg/ml<br />
Enzyme Inoculum Cefotaxime Cefepime Imipenem<br />
SHV-3 5 x 10 5 8 2 0.06<br />
SHV-3 5 x 10 7 1024 1024 0.5<br />
19
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