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
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CLSI Carbapenem Testing: Enterobacteriaceae<br />
• 2010 Susceptible Breakpoints (supplement to M100-S20)<br />
• Doripenem, imipenem, meropenem < 1 µg/ml<br />
• Ertapenem < 0.25 µg/ml (to be reviewed)<br />
• No carbapenemase test for therapy<br />
• If New Breakpoints Not Used, Screen <strong>and</strong> Confirm All Types<br />
<strong>of</strong> Carbapenemases (M100-S19)<br />
• Screen – MIC 2 ertapenem, 2-4 imipenem/meropenem<br />
plus<br />
• Resistance to cefotaxime, ceftriaxone, ceftazidime,<br />
cefoperazone or ceftizoxime<br />
• Confirmation – “Modified Hodge Test”<br />
• If positive <strong>and</strong> isolate is carbapenem-susceptible, report MIC<br />
without interpretation<br />
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