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Panel:   Imipenem/relebactam (IMR)
AR Bank # 0504 Klebsiella pneumoniae
Study ID: IMR-04

Biosample Accession #: SAMN11953947

   

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:  Imipenem/relebactam (IMR)


MIC (μg/ml) Results and Interpretation
Drug MIC (μg/ml) INT
Amikacin 2S
Ampicillin >32R
Ampicillin/sulbactam 1>32R
Aztreonam 32R
Cefazolin >8R
Cefepime >32R
Cefotaxime >64R
Cefotaxime/clavulanic acid 1>32---
Cefoxitin 16I
Ceftazidime 16R
Ceftazidime/avibactam 1<=0.5S
Ceftazidime/clavulanic acid 14---
Ceftolozane/tazobactam 18R
Ceftriaxone >32R
Ciprofloxacin 2R
Colistin 20.5I
Doripenem >8R
Ertapenem 4R
Gentamicin 0.5S
Imipenem 16R
Imipenem/relebactam 18R
Imipenem+chelators 432---
Levofloxacin 0.5S
Meropenem 2I
Minocycline <=4S
Piperacillin/tazobactam 1>128R
Plazomicin 0.25S
Tetracycline >32R
Tigecycline 3<=0.5S
Tobramycin 8R
Trimethoprim/sulfamethoxazole 1>8R
SDD (Susceptible Dose Dependent)
S – I –R Interpretation (INT) derived from CLSI 2023 M100 S33

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 Screen for metallo-beta-lactamase production [Rasheed et al. Emerging Infectious Diseases. 2013. 19(6):870-878]
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-cr
Beta-lactam CTX-M-15, OXA-48(c), SHV-OSBL(b)
Phenicols/Bicyclomycins catB4
Tetracyclines tet(A), tet(R)
 
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
04/11/23INT was updated with a new value for Tobramycin: from 'I' to 'R'
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