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Panel:   GAIHN (Custom)
AR Bank # 0039 Klebsiella pneumoniae
Study ID: CarbaNP-08

Biosample Accession #: SAMN04014880

mCIM Result: Positive    Carba NP Result: Negative
MLST: ST34(Pasteur)


Panel:  Gram Negative Carbapenemase Detection (CarbaNP)  |  ARLN Verification (Custom)  |  GAIHN (Custom)  |  Piperacillin-tazobactam +aminoglycosides for Enterobacterales (PTA) (Custom)  |  PTA - CarbaNP set only (Custom)


MIC (μg/ml) Results and Interpretation
Drug MIC (μg/ml) INT
Amikacin 4S
Ampicillin >32R
Ampicillin/sulbactam 1>32R
Aztreonam >64R
Cefazolin >16R
Cefepime >32R
Cefepime/zidebactam 10.5---
Cefotaxime >64R
Cefotaxime/clavulanic acid 1>32---
Cefoxitin >16R
Ceftazidime >128R
Ceftazidime/avibactam 11S
Ceftazidime/clavulanic acid 164---
Ceftolozane/tazobactam 1>16R
Ceftriaxone >32R
Ciprofloxacin >8R
Colistin 40.5I
Doripenem 4R
Eravacycline 0.25S
Ertapenem 8R
Gentamicin 8R
Imipenem 4R
Imipenem+chelators 34---
Levofloxacin >8R
Meropenem 2I
Meropenem-vaborbactam 12S
Nitrofurantoin 32S
Piperacillin/tazobactam 1>128R
Plazomicin 0.25S
Tetracycline >32R
Tigecycline 21S
Tobramycin 16R
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.
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)-IId, aac(6')-Ib-cr, aadA1, aadA2, aph(3")-Ib, aph(6)-Id
Beta-lactam OXA-181, CTX-M-15, SHV-26
Efflux pumps/Other EMRD, KDEA, qacEdelta1
Fosfomycin fosA5
Macrolide-Lincosamide-Streptogramin ere(A)
Phenicols/Bicyclomycins catA1, oqxB9
Quinolone oqxB9
Rifampicin ARR-2
Sulfonamides sul1, sul2
Tetracyclines tet(A), tet(R)
Trimethoprim dfrA12, dfrA14
Truncated Porin Omp35, 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
04/20/23MIC was updated with a new value for Eravacycline: from '0.5' to '0.25'
04/17/23INT was updated with a new value for Nitrofurantoin: from '---' to 'S'
04/17/23MIC was updated with a new value for Nitrofurantoin: from '---' to '32'
04/17/23Drug was added: Nitrofurantoin
04/10/23INT was updated with a new value for Gentamicin: from 'I' to 'R'
03/09/23Gene was added to 'qacEdelta1'
03/09/23Gene was added to 'KDEA'
03/09/23Gene was added to 'EMRD'
03/09/23Gene was added to 'ere(A)'
03/09/23Gene was added to 'fosA5'
03/09/23Gene was added to 'Omp35'
03/09/23Gene was added to 'tet(R)'
03/09/23Gene was added to 'ARR-2'
03/09/23Gene was added to 'oqxB9'
03/09/23Gene was added to 'aac(6')-Ib-cr'
03/09/23Gene was added to 'aph(6)-Id'
03/09/23Gene was added to 'aph(3")-Ib'
03/09/23Gene was added to 'aadA1'
03/09/23Category was added: 'Efflux pumps/Other'
03/09/23Category was added: 'Macrolide-Lincosamide-Streptogramin'
03/09/23Category was added: 'Fosfomycin'
03/09/23Category was added: 'Quinolone'
03/09/23Gene was removed from 'from '---' to ' ARR-3''
03/09/23Gene was removed from 'from '---' to ' strB''
03/09/23Gene was removed from 'from '---' to ' strA''
12/19/22MLST was updated: from '---' to 'ST34(Pasteur)'
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