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August 30, 2023AntibioticsOpen Access

Characterization of Carbapenemase- and ESBL-Producing Gram-Negative Bacilli Isolated from Patients with Urinary Tract and Bloodstream Infections

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Authors

ITIsabella A. TicklerDKDiane E. KawaAOAnne E. Obradovich

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Overview

Surveillance study reveals high beta-lactamase diversity in clinical Gram-negative isolates, indicating diagnostic gaps in standard antibiotic susceptibility testing.

Key Points

  • To characterize beta-lactamase-mediated resistance and evaluate the accuracy of antimicrobial susceptibility testing methods among resistant Gram-negative isolates causing urinary tract and bloodstream infections.
  • Collected 361 Gram-negative bacterial isolates (199 from urinary tract infections, 162 from bloodstream infections) non-susceptible to second- or third-generation cephalosporins or carbapenems across 12 healthcare systems in the United States between May 2021 and August 2022.
  • Characterized isolates using phenotypic antimicrobial susceptibility testing (broth microdilution and disk diffusion) and whole-genome sequencing.
  • Carbapenemase genes were identified in 20.5% of isolates across 13 species (predominantly blaKPC-3 and blaKPC-2), while ESBL and AmpC genes were present in 66.2% (mainly blaCTX-M-15) and 33.2% of isolates, respectively.
  • Among blaKPC-positive organisms, 2.8% were susceptible to ertapenem, 8.3% to imipenem, and 22.2% to meropenem.
  • Disk diffusion showed high correlation with broth microdilution overall but demonstrated statistically lower detection of cefepime resistance.

Cite This Study

Tickler et al. (2023) studied this question.

synapsesocial.com/papers/6a9abe2ab648fd04489e36fchttps://doi.org/10.3390/antibiotics12091386
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