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Panel:   Isolates with New or Novel Antibiotic Resistance (NEW)
AR Bank # 1269 Pseudomonas aeruginosa
Study ID: NEW-35

Biosample Accession #: SAMN33435242

   

Collection Year: 2022
Source: Sputum
MLST: 1203

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: AR- 0349 Escherichia coli  has been removed from the collection and is now available at ATCC under catalog # BAA-3170

Panel:  Isolates with New or Novel Antibiotic Resistance (NEW)


MIC (μg/ml) Results and Interpretation
Drug MIC (μg/ml) INT
Amikacin >64R
Aztreonam >32R
Cefepime >32R
Cefiderocol 0.5S
Ceftazidime >128R
Ceftazidime/avibactam 2>16R
Ceftolozane/tazobactam 2>16R
Ciprofloxacin >8R
Colistin 30.5I
Delafloxacin 1>4R
Imipenem 16R
Imipenem/relebactam 28R
Imipenem+chelators 42---
Levofloxacin >8R
Meropenem >8R
Piperacillin/tazobactam 264R
Tobramycin >16R
S – I –R Interpretation (INT) derived from CLSI 2025 M100 S35
1 Based on FDA break points
2 Reflects MIC of first component
3 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.
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-G, aadA1, aph(3")-Ib, aph(3')-IIb, aph(6)-Id, rmtF2
Beta-lactam GES-9, OXA-10, OXA-395, PDC-19A, VIM-80
Efflux pumps/Other mexA, mexE, qacEdelta1
Fosfomycin fosA
Macrolide-Lincosamide-Streptogramin ere(A)
Phenicols/Bicyclomycins bcr1, catB, floR, floR2
Sulfonamides sul1
Tetracyclines tet(G)
Trimethoprim dfrA5
 
Disclaimer:
AR gene prediction was performed using ARG-ANNOT, ResFinder and NCBI (ResGANNCBI) databases accessed on 2021-05-07. AR drug classes are assigned according to these databases. This analysis does not include mutations that may result in antibiotic resistance or resistance determinants added to newer versions of used database or other antimicrobial resistance gene databases. 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. *Presence of Efflux Pump may not be associated with resistance. *MLST Type (and scheme), as determined by Torsten Seemann's MLST program. For Enterobacteriaceae, the Pasteur MLST schemes are used except for E. coli for which both the Pasteur and Achtman schemes are reported. SUB=novel MLST identified and "submitted". 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. Please 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.

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
06/14/23Drug was removed: 'Gentamicin'
04/12/23INT was updated with a new value for Piperacillin/tazobactam: from 'I' to 'R'
02/27/23Sequence Accession # changed: from '---' to 'SAMN33435242'
02/24/23Gene was added to 'qacEdelta1'
02/24/23Gene was added to 'mexE'
02/24/23Gene was added to 'mexA'
02/24/23Gene was added to 'dfrA5'
02/24/23Gene was added to 'tet(G)'
02/24/23Gene was added to 'sul1'
02/24/23Gene was added to 'floR2'
02/24/23Gene was added to 'floR'
02/24/23Gene was added to 'catB'
02/24/23Gene was added to 'bcr1'
02/24/23Gene was added to 'ere(A)'
02/24/23Gene was added to 'fosA'
02/24/23Gene was added to 'rmtF2'
02/24/23Gene was added to 'aph(6)-Id'
02/24/23Gene was added to 'aph(3')-IIb'
02/24/23Gene was added to 'aph(3")-Ib'
02/24/23Gene was added to 'aadA1'
02/24/23Gene was added to 'aac(6')-Ib-G'
02/24/23Gene was added to 'PDC-19A'
02/24/23Gene was added to 'OXA-395'
02/24/23Gene was added to 'OXA-10'
02/24/23Category was added: 'Efflux pumps/Other'
02/24/23Category was added: 'Trimethoprim'
02/24/23Category was added: 'Tetracyclines'
02/24/23Category was added: 'Sulfonamides'
02/24/23Category was added: 'Phenicols/Bicyclomycins'
02/24/23Category was added: 'Macrolide-Lincosamide-Streptogramin'
02/24/23Category was added: 'Fosfomycin'
02/24/23Category was added: 'Aminoglycoside'
02/22/23Collection Year was changed: from '---' to '2022'
02/17/23Isolate Status changed: from 'Pending' to 'Active'
02/17/23Isolate was removed from panel
02/17/23Isolate Status changed: from 'Active' to 'Pending'
02/17/23MIC was updated with a new value for Imipenem+chelators: from '---' to '2'
02/17/23Drug was added: Imipenem+chelators
02/17/23Isolate Status changed: from 'Pending' to 'Active'
02/17/23MIC was updated with a new value for Imipenem/relebactam: from '16' to '8'
02/17/23MLST was updated: from '---' to '1203'
02/17/23Source was changed: from '---' to 'Sputum'
02/16/23INT was updated with a new value for Delafloxacin: from '---' to 'R'
02/16/23MIC was updated with a new value for Delafloxacin: from '---' to '>4'
02/16/23Drug was added: Delafloxacin
02/14/23Gene was added to 'VIM-80'
02/14/23Gene was added to 'GES-9'
02/14/23Category was added: 'Beta-lactam'
02/14/23INT was updated with a new value for Cefiderocol: from '---' to 'S'
02/14/23INT was updated with a new value for Imipenem/relebactam: from '---' to 'R'
02/14/23INT was updated with a new value for Tobramycin: from '---' to 'R'
02/14/23INT was updated with a new value for Piperacillin/tazobactam: from '---' to 'I'
02/14/23INT was updated with a new value for Meropenem: from '---' to 'R'
02/14/23INT was updated with a new value for Levofloxacin: from '---' to 'R'
02/14/23INT was updated with a new value for Imipenem: from '---' to 'R'
02/14/23MIC was updated with a new value for Tobramycin: from '---' to '>16'
02/14/23MIC was updated with a new value for Piperacillin/tazobactam: from '---' to '64'
02/14/23MIC was updated with a new value for Meropenem: from '---' to '>8'
02/14/23MIC was updated with a new value for Levofloxacin: from '---' to '>8'
02/14/23MIC was updated with a new value for Imipenem: from '---' to '16'
02/14/23MIC was updated with a new value for Imipenem/relebactam: from '---' to '16'
02/14/23MIC was updated with a new value for Gentamicin: from '---' to '>16'
02/14/23MIC was updated with a new value for Colistin: from '---' to '0.5'
02/14/23MIC was updated with a new value for Ciprofloxacin: from '---' to '>8'
02/14/23MIC was updated with a new value for Ceftolozane/tazobactam: from '---' to '>16'
02/14/23MIC was updated with a new value for Ceftazidime: from '---' to '>128'
02/14/23MIC was updated with a new value for Ceftazidime/avibactam: from '---' to '>16'
02/14/23MIC was updated with a new value for Cefiderocol: from '---' to '0.5'
02/14/23MIC was updated with a new value for Cefepime: from '---' to '>32'
02/14/23MIC was updated with a new value for Aztreonam: from '---' to '>32'
02/14/23MIC was updated with a new value for Amikacin: from '---' to '>64'
02/14/23Drug was added: Cefiderocol
02/14/23Drug was added: Imipenem/relebactam
02/14/23Drug was added: Tobramycin
02/14/23Drug was added: Piperacillin/tazobactam
02/14/23Drug was added: Meropenem
02/14/23Drug was added: Levofloxacin
02/14/23Drug was added: Imipenem
02/14/23INT was updated with a new value for Gentamicin: from '---' to 'R'
02/14/23INT was updated with a new value for Colistin: from '---' to 'I'
02/14/23INT was updated with a new value for Ciprofloxacin: from '---' to 'R'
02/14/23INT was updated with a new value for Ceftolozane/tazobactam: from '---' to 'R'
02/14/23INT was updated with a new value for Ceftazidime/avibactam: from '---' to 'R'
02/14/23INT was updated with a new value for Ceftazidime: from '---' to 'R'
02/14/23INT was updated with a new value for Cefepime: from '---' to 'R'
02/14/23INT was updated with a new value for Aztreonam: from '---' to 'R'
02/14/23INT was updated with a new value for Amikacin: from '---' to 'R'
02/14/23MIC was updated with a new value for Tobramycin: from '---' to '>16'
02/14/23MIC was updated with a new value for Piperacillin/tazobactam: from '---' to '64'
02/14/23MIC was updated with a new value for Meropenem: from '---' to '>8'
02/14/23MIC was updated with a new value for Levofloxacin: from '---' to '>8'
02/14/23MIC was updated with a new value for Imipenem: from '---' to '16'
02/14/23MIC was updated with a new value for Imipenem/relebactam: from '---' to '16'
02/14/23MIC was updated with a new value for Gentamicin: from '---' to '>16'
02/14/23MIC was updated with a new value for Colistin: from '---' to '0.5'
02/14/23MIC was updated with a new value for Ciprofloxacin: from '---' to '>8'
02/14/23MIC was updated with a new value for Ceftolozane/tazobactam: from '---' to '>16'
02/14/23MIC was updated with a new value for Ceftazidime: from '---' to '>128'
02/14/23MIC was updated with a new value for Ceftazidime/avibactam: from '---' to '>16'
02/14/23MIC was updated with a new value for Cefiderocol: from '---' to '0.5'
02/14/23MIC was updated with a new value for Cefepime: from '---' to '>32'
02/14/23MIC was updated with a new value for Aztreonam: from '---' to '>32'
02/14/23MIC was updated with a new value for Amikacin: from '---' to '>64'
02/14/23Drug was added: Gentamicin
02/14/23Drug was added: Colistin
02/14/23Drug was added: Ciprofloxacin
02/14/23Drug was added: Ceftolozane/tazobactam
02/14/23Drug was added: Ceftazidime/avibactam
02/14/23Drug was added: Ceftazidime
02/14/23Drug was added: Cefepime
02/14/23Drug was added: Aztreonam
02/14/23Drug was added: Amikacin
02/14/23Isolate Created
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