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Panel:   Enterobacterales Carbapenemase Diversity (CRE)
AR Bank # 0129 Klebsiella pneumoniae
Study ID: CRE-18

Biosample Accession #: SAMN04014970

   

MICs obtained by broth microdilution. Modal MIC is reported.

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).

Panel:  Enterobacterales Carbapenemase Diversity (CRE)


MIC (μg/ml) Results and Interpretation
Drug MIC (μg/ml) INT
Amikacin 32I
Ampicillin >32R
Ampicillin/sulbactam 1>32R
Aztreonam >64R
Aztreonam/avibactam 10.25---
Cefazolin >32R
Cefepime 32R
Cefepime/zidebactam 40.12---
Cefotaxime >64R
Cefotaxime/clavulanic acid 116---
Cefoxitin >32R
Ceftazidime >256R
Ceftazidime/avibactam 12S
Ceftazidime/clavulanic acid 1256---
Ceftolozane/tazobactam >16R
Ceftriaxone >64R
Ciprofloxacin >8R
Colistin 20.5I
Eravacycline 30.25S
Ertapenem >16R
Gentamicin 1S
Imipenem 8R
Imipenem/relebactam 10.06S
Levofloxacin >8R
Meropenem 16R
Meropenem-vaborbactam 1<=0.25S
Nitrofurantoin >128R
Omadacycline 34S
Piperacillin/tazobactam 1128R
Tetracycline 4S
Tigecycline 31S
Tobramycin >16R
Trimethoprim/sulfamethoxazole 1>8R
S – I –R Interpretation (INT) derived from CLSI 2022 M100 S32
SDD (Susceptible Dose Dependent)
1 Reflects MIC of first component
2 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.
3 Based on FDA break points
4 Cefepime to zidebactam ratio (1:1)
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
CategoryGene
Aminoglycoside aac(6')-Ib, aadA2, aph(3')-Ia
Beta-lactam KPC-3, TEM-1A
Macrolide-Lincosamide-Streptogramin mph(A)
Phenicols/Bicyclomycins catA1
Quinolone oqxA, oqxB
Sulfonamides sul1
Trimethoprim dfrA12
Truncated Porin OmpK35
 
Disclaimer:
The resistance mechanisms listed were identified by analysis of whole genome sequence using the ResFinder database (last updated June 2, 2016 and accessed on October 25, 2016). This analysis does not include mutations that may result in antibiotic resistance or resistance determinants added to newer versions of the ResFinder database or other antimicrobial resistance gene databases. Biosample accession numbers have been provided so that users can analyze the data on their own if so desired.
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.

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.
Isolate History
Date Action Performed
05/23/23MIC was updated with a new value for Aztreonam/avibactam: from '---' to '0.25'
05/23/23Drug was added: Aztreonam/avibactam
04/20/23MIC was updated with a new value for Eravacycline: from '0.5' to '0.25'
10/27/22INT was updated with a new value for Ceftolozane/tazobactam: from '---' to 'R'
10/27/22MIC was updated with a new value for Ceftolozane/tazobactam: from '---' to '16'
10/27/22Drug was added: Ceftolozane/tazobactam
10/27/22INT was updated with a new value for Omadacycline: from '---' to 'S'
10/27/22INT was updated with a new value for Nitrofurantoin: from '---' to 'R'
10/27/22INT was updated with a new value for Meropenem-vaborbactam: from '---' to 'S'
10/27/22INT was updated with a new value for Imipenem/relebactam: from '---' to 'S'
10/27/22INT was updated with a new value for Eravacycline: from '---' to 'S'
10/27/22INT was updated with a new value for Cefepime/zidebactam: from '---' to '---'
10/27/22MIC was updated with a new value for Omadacycline: from '---' to '4'
10/27/22MIC was updated with a new value for Nitrofurantoin: from '---' to '128'
10/27/22MIC was updated with a new value for Meropenem-vaborbactam: from '---' to '=0.25'
10/27/22MIC was updated with a new value for Imipenem/relebactam: from '---' to '0.06'
10/27/22MIC was updated with a new value for Eravacycline: from '---' to '0.5'
10/27/22MIC was updated with a new value for Cefepime/zidebactam: from '---' to '0.12'
10/27/22Drug was added: Eravacycline
10/27/22Drug was added: Meropenem-vaborbactam
10/27/22Drug was added: Nitrofurantoin
10/27/22Drug was added: Omadacycline
10/27/22Drug was added: Imipenem/relebactam
10/27/22Drug was added: Cefepime/zidebactam
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