Isolate Details | Antimicrobial Resistance Isolate Bank | Antibiotic/Antimicrobial Resistance

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Panel: Multi-Mechanism (MULTI)

AR Bank # 1156 Pseudomonas aeruginosa

Study ID: MULTI-08

Biosample Accession #: SAMN34111342

mCIM Result: Positive

Collection Year: 2018
Source: Urine

MLST: ST244(Pasteur)

MICs obtained by broth microdilution. Modal MIC is reported.

MIC results for each antimicrobial agent for an isolate may commonly be ± 1 log2 (doubling dilution) different than what is posted on the FDA & CDC AR Bank website because this is the normal technical variability of antimicrobial susceptibility testing (see J. H. Jorgensen. 1993. J Clin Microbiol. Vol 31[11]: 2841-2844).

Note: This AR Bank panel includes isolates that are pan-resistant, meaning they are susceptible to none of the antimicrobial agents tested which may include those commonly used to treat infections with these organisms. This represents an additional risk to staff working with these organisms and should be considered as part of the receiving facility risk assessment required by the Biosafety Compliance Agreement. The increased difficulty in treatment of any infection with those isolates should also be a consideration in deciding which protocols to use and precautions to take for working with these isolates.

Panel: Multi-Mechanism (MULTI)

Drug	MIC (μg/ml)	INT
MIC (μg/ml) Results and Interpretation
Amikacin	>64	R
Aztreonam	>64	R
Cefepime	>32	R
Cefepime/zidebactam ²	8	---
Cefiderocol	8	I
Ceftazidime	>128	R
Ceftazidime/avibactam ¹	>16	R
Ciprofloxacin	>8	R
Colistin ^{1 4}	>8	R
Imipenem	>64	R
Imipenem/relebactam ¹	>64	R
Imipenem+chelators ³	>32	---
Levofloxacin	>8	R
Meropenem	>8	R
Piperacillin/tazobactam ¹	>128	R
Tobramycin	>16	R
SDD (Susceptible Dose Dependent) S – I –R Interpretation (INT) derived from CLSI 2023 M100 S33 ¹ Reflects MIC of first component ² Cefepime to zidebactam ratio (1:1) ³ Screen for metallo-beta-lactamase production [Rasheed et al. Emerging Infectious Diseases. 2013. 19(6):870-878] ⁴ Clinical and PK/PD data demonstrate colistin has limited clinical efficacy, even if an intermediate result is obtained. Alternative agents are strongly preferred. Colistin should be used in combination with one or more active antimicrobial agents. Consultation with an infectious disease specialist is recommended.

Device manufacturers and users of FDA cleared devices shall consult the FDA’s Antibacterial Susceptibility Test Interpretive Criteria website for breakpoints recognized or recommended by FDA, and for information regarding FDA exceptions or additions to the applicable, recognized consensus standard.

Molecular Mechanisms of Resistance
Category	Gene
Aminoglycoside	aac(6')-IB3, aph(3')-IIb, aph(6)-Id, strA
Beta-lactam	IMP-1, NDM-1, LCR-1, OXA-10, OXA-129, OXA-847, PAO, PAU-1, PME-1, TEM-1
Efflux pumps/Other	mexA, mexE, mexX, qacEdelta1
Fosfomycin	fosA
Macrolide-Lincosamide-Streptogramin	mph(A), mph(E), msr(E)
Phenicols/Bicyclomycins	bcr1, catB7, floR2
Quinolone	QnrVC1
Rifampicin	ARR-2
Sulfonamides	sul1
Tetracyclines	tet(G)

Disclaimer: Antimicrobial Resistance (AR) gene prediction was performed using a combined and deduplicated AR database (ResGANNCBI) from ARG-ANNOT, ResFinder and NCBI AMRFinder accessed on 2021-05-07. AR drug classes are assigned according to these databases. This analysis does not include mutations that may result in antimicrobial resistance, or resistance determinants added to newer versions of databases used, or other antimicrobial resistance gene databases. Additional AR genes other than those listed, may be present. For resistance determinant detection, 99-100% sequence identity and 100% sequence coverage from GAMMA and SRST2 was used. GAMMA uses amino acid sequence to assign gene alleles from assemblies; SRST2 uses nucleotide sequence to assign gene alleles from sequencing reads. Biosample accession numbers have been provided so that users can analyze the data on their own, if so desired. *MLST Type (and scheme), as determined by Torsten Seemann's MLST program. For Enterobacterales the Pasteur MLST schemes are used except for E. coli for which both the Pasteur and Achtman schemes are reported. Similarly, for Acinetobacter baumannii complex, both Pasteur and Oxford MLST schemes are used and reported. SUB=novel MLST identified and "submitted". Dash (-) indicates no pubMLST scheme is available for that species.

Propagation

MEDIUM
Medium: Trypticase Soy Agar with 5% Sheep Blood (BAP)

GROWTH CONDITIONS
Temperature: 35°C
Atmosphere: Aerobic

PROPAGATION PROCEDURE
Remove the sample vial to a container with dry ice or a freezer block. Keep vial on ice or block. (Do not let vial content thaw)

Open vial aseptically to avoid contamination.

Using a sterile loop, remove a small amount of frozen isolate from the top of the vial

Aseptically transfer the loop to BAP

Use streak plate method to isolate single colonies

Incubate inverted plate at 35°C ± 2°C for 18-24 hrs.

Storage Temperature & Biosafety

STORAGE TEMPERATURE: -70°C

BIOSAFETY LEVEL: 2
Appropriate safety procedures should always be used with this material. Laboratory safety is discussed in the current publication of 'BioSafety in Microbiological and Biomedical Laboratories' from the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, and National Institutes of Health. This AR Bank panel includes isolates that are pan-resistant, meaning they are susceptible to none of the antimicrobial agents tested which may include those commonly used to treat infections with these organisms. This represents an additional risk to staff working with these organisms and should be considered as part of the receiving facility risk assessment required by the Biosafety Compliance Agreement. The increased difficulty in treatment of any infection with those isolates should also be a consideration in deciding which protocols to use and precautions to take for working with these isolates.

Disclaimer:
This product is sent with the condition that you are responsible for its safe storage, handling, and use. All materials are the property of the Centers for Disease Control and Prevention (CDC) and have been made available on behalf of the Food and Drug Administration (FDA). This material is not for use in human subjects and may not be redistributed. While CDC uses reasonable efforts to include accurate and up-to-date information on this product sheet, CDC makes no warranties or representations as to its accuracy. CDC is not liable for damages arising from the misidentification or misrepresentation of cultures. Please refer to the Standard Letter Agreement (SLA) for further details regarding the use of this product.

Date	Action Performed
Isolate History
11/20/23	INT was updated with a new value for Colistin: from '---' to 'R'
11/20/23	MIC was updated with a new value for Colistin: from '---' to '>8'
11/20/23	Drug was added: 'Colistin'
07/13/23	Sequence Accession # changed: from '---' to 'SAMN34111342'
06/14/23	Drug was removed: 'Gentamicin'
04/12/23	INT was updated with a new value for Gentamicin: from '---' to 'R'
04/12/23	INT was updated with a new value for Ciprofloxacin: from '---' to 'R'
04/12/23	MIC was updated with a new value for Gentamicin: from '---' to '>16'
04/12/23	MIC was updated with a new value for Ciprofloxacin: from '---' to '>8'
04/12/23	Drug was added: Gentamicin
04/12/23	Drug was added: Ciprofloxacin
02/24/23	Isolate Status changed: from 'Pending' to 'Active'
02/24/23	Isolate was removed from panel
02/24/23	Isolate Status changed: from 'Active' to 'Pending'
02/24/23	Source was changed: from '---' to 'Urine'
02/24/23	Collection Year was changed: from '---' to '2018'
02/24/23	mCIM changed: from '---' to 'Positive'
02/22/23	Isolate Status changed: from 'Pending' to 'Active'
02/22/23	INT was updated with a new value for Cefiderocol: from 'R' to 'I'
02/06/23	Gene was added to 'qacEdelta1'
02/06/23	Gene was added to 'mexX'
02/06/23	Gene was added to 'mexE'
02/06/23	Gene was added to 'mexA'
02/06/23	Gene was added to 'tet(G)'
02/06/23	Gene was added to 'sul1'
02/06/23	Gene was added to 'ARR-2'
02/06/23	Gene was added to 'floR2'
02/06/23	Category was added: 'Efflux pumps/Other'
02/06/23	Category was added: 'Tetracyclines'
02/06/23	Category was added: 'Sulfonamides'
02/06/23	Category was added: 'Rifampicin'
02/06/23	Gene was added to 'catB7'
02/06/23	Gene was added to 'bcr1'
02/06/23	Gene was added to 'msr(E)'
02/06/23	Gene was added to 'mph(E)'
02/06/23	Gene was added to 'mph(A)'
02/06/23	Gene was added to 'fosA'
02/06/23	Gene was added to 'QnrVC1'
02/06/23	Gene was added to 'strA'
02/06/23	Gene was added to 'aph(6)-Id'
02/06/23	Gene was added to 'aph(3')-IIb'
02/06/23	Gene was added to 'aac(6')-IB3'
02/06/23	Gene was added to 'PME-1'
02/06/23	Gene was added to 'PAU-1'
02/06/23	Gene was added to 'OXA-847'
02/06/23	Category was added: 'Phenicols/Bicyclomycins'
02/06/23	Category was added: 'Macrolide-Lincosamide-Streptogramin'
02/06/23	Category was added: 'Fosfomycin'
02/06/23	Category was added: 'Quinolone'
02/06/23	Category was added: 'Aminoglycoside'
02/06/23	Gene was added to 'TEM-1'
02/06/23	Gene was added to 'PAO'
02/06/23	Gene was added to 'OXA-129'
02/06/23	Gene was added to 'OXA-10'
02/06/23	Gene was added to 'NDM-1'
02/06/23	Gene was added to 'LCR-1'
02/06/23	MLST was updated: from '---' to 'ST244(Pasteur)'
02/06/23	Gene was added to 'IMP-1'
02/06/23	Category was added: 'Beta-lactam'
02/06/23	MIC was updated with a new value for Imipenem/relebactam: from '>16' to '>64'
02/03/23	Drug was removed: 'Minocycline'
02/03/23	INT was updated with a new value for Cefiderocol: from '---' to 'R'
02/03/23	Drug was removed: 'Nitrofurantoin'
02/03/23	Drug was removed: 'Omadacycline'
02/03/23	Drug was removed: 'Meropenem-vaborbactam'
02/03/23	Drug was removed: 'Plazomicin'
02/03/23	Drug was removed: 'Trimethoprim/sulfamethoxazole'
02/03/23	Drug was removed: 'Tigecycline'
02/03/23	Drug was removed: 'Tetracycline'
02/03/23	Drug was removed: 'Cefoxitin'
02/03/23	Drug was removed: 'Cefotaxime/clavulanic acid'
02/03/23	Drug was removed: 'Cefotaxime'
02/03/23	Drug was removed: 'Ampicillin/sulbactam'
02/03/23	Drug was removed: 'Ampicillin'
02/03/23	MIC was updated with a new value for Cefiderocol: from '---' to '8'
02/03/23	Drug was added: Cefiderocol
02/03/23	INT was updated with a new value for Nitrofurantoin: from '---' to '---'
02/03/23	INT was updated with a new value for Omadacycline: from '---' to '---'
02/03/23	INT was updated with a new value for Meropenem-vaborbactam: from '---' to '---'
02/03/23	INT was updated with a new value for Plazomicin: from '---' to '---'
02/03/23	INT was updated with a new value for Cefepime/zidebactam: from '---' to '---'
02/03/23	INT was updated with a new value for Imipenem/relebactam: from '---' to 'R'
02/03/23	INT was updated with a new value for Trimethoprim/sulfamethoxazole: from '---' to '---'
02/03/23	INT was updated with a new value for Tobramycin: from '---' to 'R'
02/03/23	MIC was updated with a new value for Trimethoprim/sulfamethoxazole: from '---' to '>8'
02/03/23	MIC was updated with a new value for Tobramycin: from '---' to '>16'
02/03/23	MIC was updated with a new value for Tigecycline: from '---' to '>4'
02/03/23	MIC was updated with a new value for Tetracycline: from '---' to '>32'
02/03/23	MIC was updated with a new value for Plazomicin: from '---' to '>8'
02/03/23	MIC was updated with a new value for Piperacillin/tazobactam: from '---' to '>128'
02/03/23	MIC was updated with a new value for Omadacycline: from '---' to '>32'
02/03/23	MIC was updated with a new value for Nitrofurantoin: from '---' to '>128'
02/03/23	MIC was updated with a new value for Minocycline: from '---' to '>16'
02/03/23	MIC was updated with a new value for Meropenem-vaborbactam: from '---' to '>16'
02/03/23	MIC was updated with a new value for Meropenem: from '---' to '>8'
02/03/23	MIC was updated with a new value for Levofloxacin: from '---' to '>8'
02/03/23	MIC was updated with a new value for Imipenem+chelators: from '---' to '>32'
02/03/23	MIC was updated with a new value for Imipenem: from '---' to '>64'
02/03/23	MIC was updated with a new value for Imipenem/relebactam: from '---' to '>16'
02/03/23	MIC was updated with a new value for Ceftazidime: from '---' to '>128'
02/03/23	MIC was updated with a new value for Ceftazidime/avibactam: from '---' to '>16'
02/03/23	MIC was updated with a new value for Cefoxitin: from '---' to '>16'
02/03/23	MIC was updated with a new value for Cefotaxime: from '---' to '>64'
02/03/23	MIC was updated with a new value for Cefotaxime/clavulanic acid: from '---' to '>32'
02/03/23	MIC was updated with a new value for Cefepime: from '---' to '>32'
02/03/23	MIC was updated with a new value for Cefepime/zidebactam: from '---' to '8'
02/03/23	MIC was updated with a new value for Aztreonam: from '---' to '>64'
02/03/23	MIC was updated with a new value for Ampicillin: from '---' to '>32'
02/03/23	MIC was updated with a new value for Ampicillin/sulbactam: from '---' to '>32'
02/03/23	MIC was updated with a new value for Amikacin: from '---' to '>64'
02/03/23	Drug was added: Nitrofurantoin
02/03/23	Drug was added: Omadacycline
02/03/23	Drug was added: Meropenem-vaborbactam
02/03/23	Drug was added: Plazomicin
02/03/23	Drug was added: Cefepime/zidebactam
02/03/23	Drug was added: Imipenem/relebactam
02/03/23	Drug was added: Trimethoprim/sulfamethoxazole
02/03/23	Drug was added: Tobramycin
02/03/23	INT was updated with a new value for Tigecycline: from '---' to '---'
02/03/23	INT was updated with a new value for Tetracycline: from '---' to '---'
02/03/23	INT was updated with a new value for Piperacillin/tazobactam: from '---' to 'R'
02/03/23	INT was updated with a new value for Minocycline: from '---' to '---'
02/03/23	INT was updated with a new value for Meropenem: from '---' to 'R'
02/03/23	INT was updated with a new value for Levofloxacin: from '---' to 'R'
02/03/23	INT was updated with a new value for Imipenem+chelators: from '---' to '---'
02/03/23	INT was updated with a new value for Imipenem: from '---' to 'R'
02/03/23	MIC was updated with a new value for Trimethoprim/sulfamethoxazole: from '---' to '>8'
02/03/23	MIC was updated with a new value for Tobramycin: from '---' to '>16'
02/03/23	MIC was updated with a new value for Tigecycline: from '---' to '>4'
02/03/23	MIC was updated with a new value for Tetracycline: from '---' to '>32'
02/03/23	MIC was updated with a new value for Plazomicin: from '---' to '>8'
02/03/23	MIC was updated with a new value for Piperacillin/tazobactam: from '---' to '>128'
02/03/23	MIC was updated with a new value for Omadacycline: from '---' to '>32'
02/03/23	MIC was updated with a new value for Nitrofurantoin: from '---' to '>128'
02/03/23	MIC was updated with a new value for Minocycline: from '---' to '>16'
02/03/23	MIC was updated with a new value for Meropenem-vaborbactam: from '---' to '>16'
02/03/23	MIC was updated with a new value for Meropenem: from '---' to '>8'
02/03/23	MIC was updated with a new value for Levofloxacin: from '---' to '>8'
02/03/23	MIC was updated with a new value for Imipenem+chelators: from '---' to '>32'
02/03/23	MIC was updated with a new value for Imipenem: from '---' to '>64'
02/03/23	MIC was updated with a new value for Imipenem/relebactam: from '---' to '>16'
02/03/23	MIC was updated with a new value for Ceftazidime: from '---' to '>128'
02/03/23	MIC was updated with a new value for Ceftazidime/avibactam: from '---' to '>16'
02/03/23	MIC was updated with a new value for Cefoxitin: from '---' to '>16'
02/03/23	MIC was updated with a new value for Cefotaxime: from '---' to '>64'
02/03/23	MIC was updated with a new value for Cefotaxime/clavulanic acid: from '---' to '>32'
02/03/23	MIC was updated with a new value for Cefepime: from '---' to '>32'
02/03/23	MIC was updated with a new value for Cefepime/zidebactam: from '---' to '8'
02/03/23	MIC was updated with a new value for Aztreonam: from '---' to '>64'
02/03/23	MIC was updated with a new value for Ampicillin: from '---' to '>32'
02/03/23	MIC was updated with a new value for Ampicillin/sulbactam: from '---' to '>32'
02/03/23	MIC was updated with a new value for Amikacin: from '---' to '>64'
02/03/23	INT was updated with a new value for Ceftazidime/avibactam: from '---' to 'R'
02/03/23	Drug was added: Tigecycline
02/03/23	Drug was added: Tetracycline
02/03/23	Drug was added: Piperacillin/tazobactam
02/03/23	Drug was added: Minocycline
02/03/23	Drug was added: Meropenem
02/03/23	Drug was added: Levofloxacin
02/03/23	Drug was added: Imipenem+chelators
02/03/23	Drug was added: Imipenem
02/03/23	INT was updated with a new value for Ceftazidime: from '---' to 'R'
02/03/23	INT was updated with a new value for Cefoxitin: from '---' to '---'
02/03/23	INT was updated with a new value for Cefotaxime/clavulanic acid: from '---' to '---'
02/03/23	INT was updated with a new value for Cefotaxime: from '---' to '---'
02/03/23	INT was updated with a new value for Cefepime: from '---' to 'R'
02/03/23	INT was updated with a new value for Aztreonam: from '---' to 'R'
02/03/23	INT was updated with a new value for Ampicillin/sulbactam: from '---' to '---'
02/03/23	INT was updated with a new value for Ampicillin: from '---' to '---'
02/03/23	MIC was updated with a new value for Trimethoprim/sulfamethoxazole: from '---' to '>8'
02/03/23	MIC was updated with a new value for Tobramycin: from '---' to '>16'
02/03/23	MIC was updated with a new value for Tigecycline: from '---' to '>4'
02/03/23	MIC was updated with a new value for Tetracycline: from '---' to '>32'
02/03/23	MIC was updated with a new value for Plazomicin: from '---' to '>8'
02/03/23	MIC was updated with a new value for Piperacillin/tazobactam: from '---' to '>128'
02/03/23	MIC was updated with a new value for Omadacycline: from '---' to '>32'
02/03/23	MIC was updated with a new value for Nitrofurantoin: from '---' to '>128'
02/03/23	MIC was updated with a new value for Minocycline: from '---' to '>16'
02/03/23	MIC was updated with a new value for Meropenem-vaborbactam: from '---' to '>16'
02/03/23	MIC was updated with a new value for Meropenem: from '---' to '>8'
02/03/23	MIC was updated with a new value for Levofloxacin: from '---' to '>8'
02/03/23	MIC was updated with a new value for Imipenem+chelators: from '---' to '>32'
02/03/23	MIC was updated with a new value for Imipenem: from '---' to '>64'
02/03/23	MIC was updated with a new value for Imipenem/relebactam: from '---' to '>16'
02/03/23	MIC was updated with a new value for Ceftazidime: from '---' to '>128'
02/03/23	MIC was updated with a new value for Ceftazidime/avibactam: from '---' to '>16'
02/03/23	MIC was updated with a new value for Cefoxitin: from '---' to '>16'
02/03/23	MIC was updated with a new value for Cefotaxime: from '---' to '>64'
02/03/23	MIC was updated with a new value for Cefotaxime/clavulanic acid: from '---' to '>32'
02/03/23	MIC was updated with a new value for Cefepime: from '---' to '>32'
02/03/23	MIC was updated with a new value for Cefepime/zidebactam: from '---' to '8'
02/03/23	MIC was updated with a new value for Aztreonam: from '---' to '>64'
02/03/23	MIC was updated with a new value for Ampicillin: from '---' to '>32'
02/03/23	MIC was updated with a new value for Ampicillin/sulbactam: from '---' to '>32'
02/03/23	MIC was updated with a new value for Amikacin: from '---' to '>64'
02/03/23	INT was updated with a new value for Amikacin: from '---' to 'R'
02/03/23	Drug was added: Ceftazidime/avibactam
02/03/23	Drug was added: Ceftazidime
02/03/23	Drug was added: Cefoxitin
02/03/23	Drug was added: Cefotaxime/clavulanic acid
02/03/23	Drug was added: Cefotaxime
02/03/23	Drug was added: Cefepime
02/03/23	Drug was added: Aztreonam
02/03/23	Drug was added: Ampicillin/sulbactam
02/03/23	Drug was added: Ampicillin
02/03/23	MIC was updated with a new value for Trimethoprim/sulfamethoxazole: from '---' to '>8'
02/03/23	MIC was updated with a new value for Tobramycin: from '---' to '>16'
02/03/23	MIC was updated with a new value for Tigecycline: from '---' to '>4'
02/03/23	MIC was updated with a new value for Tetracycline: from '---' to '>32'
02/03/23	MIC was updated with a new value for Plazomicin: from '---' to '>8'
02/03/23	MIC was updated with a new value for Piperacillin/tazobactam: from '---' to '>128'
02/03/23	MIC was updated with a new value for Omadacycline: from '---' to '>32'
02/03/23	MIC was updated with a new value for Nitrofurantoin: from '---' to '>128'
02/03/23	MIC was updated with a new value for Minocycline: from '---' to '>16'
02/03/23	MIC was updated with a new value for Meropenem-vaborbactam: from '---' to '>16'
02/03/23	MIC was updated with a new value for Meropenem: from '---' to '>8'
02/03/23	MIC was updated with a new value for Levofloxacin: from '---' to '>8'
02/03/23	MIC was updated with a new value for Imipenem+chelators: from '---' to '>32'
02/03/23	MIC was updated with a new value for Imipenem: from '---' to '>64'
02/03/23	MIC was updated with a new value for Imipenem/relebactam: from '---' to '>16'
02/03/23	MIC was updated with a new value for Ceftazidime: from '---' to '>128'
02/03/23	MIC was updated with a new value for Ceftazidime/avibactam: from '---' to '>16'
02/03/23	MIC was updated with a new value for Cefoxitin: from '---' to '>16'
02/03/23	MIC was updated with a new value for Cefotaxime: from '---' to '>64'
02/03/23	MIC was updated with a new value for Cefotaxime/clavulanic acid: from '---' to '>32'
02/03/23	MIC was updated with a new value for Cefepime: from '---' to '>32'
02/03/23	MIC was updated with a new value for Cefepime/zidebactam: from '---' to '8'
02/03/23	MIC was updated with a new value for Aztreonam: from '---' to '>64'
02/03/23	MIC was updated with a new value for Ampicillin: from '---' to '>32'
02/03/23	MIC was updated with a new value for Ampicillin/sulbactam: from '---' to '>32'
02/03/23	MIC was updated with a new value for Amikacin: from '---' to '>64'
02/03/23	Drug was added: Amikacin
08/01/22	Isolate Created

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