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Panel:   Gram Negative Carbapenemase Detection (CarbaNP)
AR Bank # 0034 Klebsiella pneumoniae
Study ID: CarbaNP-03

Biosample Accession #: SAMN04014875

mCIM Result: Positive    Carba NP Result: Positive
MLST: ST17(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:  Gram Negative Carbapenemase Detection (CarbaNP)  |  ARLN Verification (Custom)  |  Cefiderocol Verification (FDC) (Custom)  |  GAIHN (Custom)


MIC (μg/ml) Results and Interpretation
Drug MIC (μg/ml) INT
Amikacin 2S
Ampicillin >32R
Ampicillin/sulbactam 1>32R
Aztreonam <=2S
Aztreonam/avibactam 50.06---
Cefazolin >8R
Cefepime 4SDD
Cefepime/zidebactam 10.12---
Cefiderocol 21S
Cefotaxime 32R
Cefotaxime/clavulanic acid 132---
Cefoxitin >16R
Ceftazidime 128R
Ceftazidime/avibactam 1>16R
Ceftazidime/clavulanic acid 164---
Ceftolozane/tazobactam 1>16R
Ceftriaxone >32R
Ciprofloxacin 0.5I
Colistin 40.5I
Doripenem 2I
Ertapenem 2R
Gentamicin >16R
Imipenem 1S
Imipenem/relebactam 12I
Imipenem+chelators 3<=0.25---
Levofloxacin 0.5S
Meropenem 2I
Meropenem-vaborbactam 14S
Minocycline <=4S
Nitrofurantoin 64I
Omadacycline 22S
Piperacillin/tazobactam 18S
Plazomicin 0.25S
Tetracycline <=2S
Tigecycline 2<=0.5S
Tobramycin 8R
Trimethoprim/sulfamethoxazole 11S
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 Reflects MIC of the combination
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-G
Beta-lactam IMP-4, SHV-11, TEM-1
Efflux pumps/Other EMRD, KDEA, qacEdelta1, qacG2
Macrolide-Lincosamide-Streptogramin mph(A)
Phenicols/Bicyclomycins catB3
Quinolone oqxA, oqxB25, QnrB2
Sulfonamides sul1
 
Disclaimer:
AR gene prediction was performed using ARG-ANNOT, ResFinder and NCBI (ResGANNCBI) databases accessed on 2022-09-16. 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. *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".
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
01/08/24MIC was updated with a new value for Minocycline: from '---' to '<=4'
05/31/23INT was updated with a new value for Omadacycline: from '---' to 'S'
05/31/23MIC was updated with a new value for Omadacycline: from '---' to '2'
05/31/23Drug was added: Omadacycline
05/18/23MIC was updated with a new value for Aztreonam/avibactam: from '---' to '0.06'
05/18/23Drug was added: Aztreonam/avibactam
04/10/23INT was updated with a new value for Tobramycin: from 'I' to 'R'
03/09/23Gene was added to 'qacG2'
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 'oqxB25'
03/09/23Gene was added to 'TEM-1'
03/09/23Gene was added to 'aac(6')-Ib-G'
03/09/23Category was added: 'Efflux pumps/Other'
03/09/23Gene was removed from 'from '---' to ' TEM-1B''
12/19/22MLST was updated: from '---' to 'ST17(Pasteur)'
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