title: Temocillin and meropenem to discriminate resistance mechanisms leading to decreased carbapenem susceptibility with focus on OXA-48 in Enterobacteriaceae.
abstract: A temocillin minimal inhibitory concentration ≥ 128 mg/L combined with the results of meropenem double disc synergy testing was used to (i) discriminate carbapenemase production from other resistance mechanisms leading to decreased carbapenem susceptibility; and (ii) differentiate Ambler classes in carbapenemase-producing enterobacteriaceae (CPE). The suggested test algorithm discriminated all extended spectrum ß-lactamase/AmpC from CPE isolates, which could further be divided correctly into Ambler classes A and B enzymes as well as OXA-48 in all cases. The algorithm is simple to implement as part of the daily routine in a standard microbiology laboratory with limited access to or resources for molecular biological tools.
authors: Institute of Hygiene, Microbiology and Tropical Medicine, National Reference Centre for Nosocomial Infections and Antimicrobial Resistance, Elisabethinen Hospital, Linz, Austria.
authors: R
authors: R
authors: Hartl
authors: S
authors: S
authors: Widhalm
authors: H
authors: H
authors: Kerschner
authors: P
authors: P
authors: Apfalter
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015780:Carbapenems / Q000494:pharmacology*; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000382:microbiology; D006801:Humans; D000077731:Meropenem; D008826:Microbial Sensitivity Tests / Q000379:methods; D010406:Penicillins / Q000494:pharmacology*; D013845:Thienamycins / Q000494:pharmacology*; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D010406:Penicillins; D013845:Thienamycins; C031367:temocillin; D001618:beta-Lactamases; D000077731:Meropenem