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Panel:   Ceftolozane/tazobactam (CTV)
AR Bank # 0375 Klebsiella oxytoca
Study ID: CTV-25

Biosample Accession #: SAMN07291518
MLST: ST52(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).

Panel:  Ceftolozane/tazobactam (CTV)  |  Klebsiella Custom  (Custom)


MIC (μg/ml) Results and Interpretation
Drug MIC (μg/ml) INT
Amikacin 2S
Ampicillin >32R
Ampicillin/sulbactam 18S
Aztreonam >64R
Cefazolin >8R
Cefepime 2S
Cefotaxime 16R
Cefotaxime/clavulanic acid 1 5<=0.25---
Cefoxitin 8S
Ceftazidime 128R
Ceftazidime/avibactam 1<=0.5S
Ceftazidime/clavulanic acid 1 5<=0.5---
Ceftolozane/tazobactam 10.25S
Ceftriaxone 32R
Ciprofloxacin <=0.25S
Colistin 4<=0.25I
Doripenem <=0.12S
Ertapenem <=0.12S
Gentamicin 2S
Imipenem <=0.5S
Imipenem+chelators 3<=0.25---
Levofloxacin <=0.12S
Meropenem <=0.12S
Meropenem-vaborbactam 1<=0.5S
Piperacillin/tazobactam 1<=4S
Tetracycline <=2S
Tigecycline 2<=0.5S
Tobramycin 8R
Trimethoprim/sulfamethoxazole 1>8R
S – I –R Interpretation (INT) derived from CLSI 2024 M100 S34
1 Reflects MIC of first component
2 Based on FDA break points
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.
5 Screen test for Extended-Spectrum-β-lactamase (ESBL) production (CLSI M100). Per CLSI, use of the ESBL test is limited to isolates of Klebsiella pneumoniae, K. oxytoca, Escherichia coli, and Proteus mirabilis. It should be noted that the presence of other β-lactamases (carbapenemases and/or AmpC) or porin alterations can mask the ESBL production and confound the interpretation of the ESBL screen test.
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(3)-Ia, aac(6')-IB3, aadA1, aph(3')-Ia
Beta-lactam OXY-1-5, SHV-5
Efflux pumps/Other qacEdelta1
Sulfonamides sul1
Trimethoprim dfrA1
 
Disclaimer:

Antimicrobial Resistance (AR) gene prediction was performed using a combined and deduplicated AR database (ResGANNCBI) from ResFinder, ARG-ANNOT, and NCBI AMRFinder(primary Database) accessed on 2022-09-15. 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 (primary AR gene calling tool) 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 and is used to resolve AR gene calls located on the edges of assembly scaffolds detected by GAMMA. Biosample accession numbers have been provided so that users can analyze the raw sequencing 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.

Truncated porins are defined as porin genes detected with ≥80% sequence identity and ≥80% sequence coverage and predicted to have an internal stop codon by c-SSTAR (https://github.com/chrisgulvik/c-SSTAR).

** Prescence of Efflux Pump may not be associated with resistance.

For additional gene information please visit the Reference Gene Catalog - Pathogen Detection – NCBI (https://www.ncbi.nlm.nih.gov/pathogens/refgene), a non-redundant database of bacterial genes related to antimicrobial resistance, biocide and stress resistance, general efflux, virulence, or antigenicity.

For additional gene information please visit the Reference Gene Catalog - Pathogen Detection - NCBI (https://www.ncbi.nlm.nih.gov/pathogens/refgene), a non-redundant database of bacterial genes related to antimicrobial resistance, biocide and stress resistance, general efflux, virulence, or antigenicity.
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
06/06/23INT was updated with a new value for Meropenem-vaborbactam: from '---' to 'S'
06/06/23MIC was updated with a new value for Meropenem-vaborbactam: from '---' to '<=0.5'
06/06/23Drug was added: Meropenem-vaborbactam
04/11/23INT was updated with a new value for Tobramycin: from 'I' to 'R'
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