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Panel:   IMP-Type Metallo-ß-Lactamase (IMP)
AR Bank # 1109 Enterobacter cloacae complex
Study ID: IMP-01

Biosample Accession #: SAMN28842366

mCIM Result: Positive    

Collection Year: 2016
Location: USA
Source: Urine
MLST: 171(Pasteur)

MICs obtained by broth microdilution. Modal MIC is reported.

Note: MCR-9 gene in this isolate is not associated with colistin resistance 

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:  IMP-Type Metallo-ß-Lactamase (IMP)  |  GAIHN (Custom)


MIC (μg/ml) Results and Interpretation
Drug MIC (μg/ml) INT
Amikacin <=1S
Ampicillin >32R
Ampicillin/sulbactam 1>32R
Aztreonam >64R
Cefepime 16R
Cefepime/zidebactam 51---
Cefiderocol 1S
Cefotaxime >64R
Cefotaxime/clavulanic acid 1>32---
Cefoxitin >16R
Ceftazidime >128R
Ceftazidime/avibactam 1>16R
Ceftolozane/tazobactam 1>16R
Ceftriaxone >32R
Ciprofloxacin >8R
Colistin 4<=0.25I
Delafloxacin 3>4R
Eravacycline 30.5S
Ertapenem 4R
Gentamicin 4I
Imipenem <=0.5S
Imipenem/relebactam 1<=0.25S
Imipenem+chelators 2<=0.25---
Levofloxacin >8R
Meropenem 0.25S
Meropenem-vaborbactam 1<=0.5S
Minocycline 16R
Nitrofurantoin 128R
Omadacycline 38I
Piperacillin/tazobactam 1>128R
Plazomicin <=0.25S
Tetracycline 8S
Tigecycline 31S
Tobramycin 4I
Trimethoprim/sulfamethoxazole 1>8R
SDD (Susceptible Dose Dependent)
S – I –R Interpretation (INT) derived from CLSI 2024 M100 S34
1 Reflects MIC of first component
2 Screen for metallo-beta-lactamase production [Rasheed et al. Emerging Infectious Diseases. 2013. 19(6):870-878]
3 Based on FDA break points
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 Cefepime to zidebactam ratio (1:1)
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 ant(2")-la, aph(3')-Ia
Beta-lactam IMP-13, ACT-45, TEM-1
Colistin mcr-9
Macrolide-Lincosamide-Streptogramin ere(A)
Phenicols/Bicyclomycins catB3
Quinolone QnrB48
Sulfonamides sul1
Trimethoprim dfrA19
 
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 2021-05-07. 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.
Propagation
MEDIUM
Medium: Trypticase Soy Agar with 5% Sheep Blood (BAP); Brain Heart Infusion Agar with 5% Rabbit Blood (BHIA)

GROWTH CONDITIONS
Temperature: 35°C
Atmosphere: Ambient

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
04/20/23INT was updated with a new value for Eravacycline: from 'NS' to 'S'
04/20/23MIC was updated with a new value for Eravacycline: from '1' to '0.5'
04/12/23INT was updated with a new value for Tobramycin: from 'S' to 'I'
04/12/23INT was updated with a new value for Gentamicin: from 'S' to 'I'
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