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Abstract
Aim: Carbapenems are antibiotics reserved for treatment of severe infections. Carbapenem antimicrobial susceptibility testing profiles were determined in a population of Klebsiella pneumoniae, and their resistance assessed based on previous and current Clinical and Laboratory Standards Institute criteria. Materials & methods: Isolates were examined using an automated antimicrobial susceptibility testing method, and real time polymerase chain reaction to detect the resistance (blaKPC) gene. Results: The prevalence of blaKPC gene was 45/54 (83.3%). Five isolates that were susceptible under the previous criteria changed to nonsusceptible with the current standards. The overall difference in susceptibility between the standards was 8%. Conclusion: This study shows that the current Clinical and Laboratory Standards Institute criteria may not offer additional benefits in the fight against carbapenem-resistant Enterobacteriaceae.
Lay abstract: Carbapenem-resistant Enterobacteriaceae (CRE) are a family of bacteria that can result in deadly infections because they are resistant to most antibiotics. We obtained 54 Klebsiella pneumonia carbapenemase isolates, a type of CRE, and determined which antibiotics were effective against them. Results showed that five isolates that were considered susceptible to an antibiotic under the previous criteria were now considered nonsusceptible with the current standards. This study shows that the current criteria may not offer additional benefits in the fight against CRE infections. Studies such as this one and prudent use of antibiotics should limit the spread of antibiotic resistance.
Acknowledgements
The authors wish to thank V Ortiz, MPH for technical review of the manuscript.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.
Author contributions
F Enyinnaya did the initial literature review, conducted all laboratory testing of isolates, conducted initial statistical analysis of results and prepared the initial article materials as part of his thesis project. P Cruz monitored and coordinated the experimental design, facilitated the transfer of clinical isolates for the study, incorporated revisions and critically reviewed the thesis and manuscript. MP Buttner conceived the experimental design, oversaw the initial literature review, supervised performance of PCR testing and critically reviewed the thesis. C Cross provided validation and statistical evaluation of the data findings, and conducted statistical analyses. DR Woodard provided support in obtaining clinical isolates for the study, reviewed the data in context of relevance to CLSI standards and developed the draft manuscript from the original material.
All authors conducted final review of the manuscript.