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
K. pneumoniae: DHA-1 + Porin Loss • 11 pts infected – all carbapenem-resistant (MDR) 2 improved with antibiotic Rx 9/11 died in 30 days (81.8%) • Risk factors Infection by DHA-1 K. pneumoniae Carbapenem Rx in previous 3 months Advanced Age Long hospital stay Pers. comm. S. H. Jeong, Yonsei Univ. College Med. Seoul, Korea
Klebsiella pneumoniae 225 Resistant Penicillins Penicillin-inhibitor combinations 1st & 2nd gen cephalosporins ceftriaxone, cefotaxime, ceftazidime, aztreonam cefoxitin aminoglycosides, trimethoprim/sulfa, chloramphenicol Susceptible Imipenem and fluoroquinolones
- 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 18 and 19: 2010 Breakpoints: Are they sufficie
- 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: Clinical Significance of AmpC for K
- 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!
Klebsiella pneumoniae 225<br />
Resistant<br />
Penicillins<br />
Penicillin-inhibitor combinations<br />
1st & 2nd gen cephalosporins<br />
ceftriaxone, cefotaxime, ceftazidime, aztreonam<br />
cefoxitin<br />
aminoglycosides, trimethoprim/sulfa, chloramphenicol<br />
Susceptible<br />
Imipenem <strong>and</strong> fluoroquinolones