Volume 21, Number 9—September 2015
THEME ISSUE
Emerging Infections Program
Emerging Infections Program
Improved Phenotype-Based Definition for Identifying Carbapenemase Producers among Carbapenem-Resistant Enterobacteriaceae
Table 1
Antimicrobial included | Study inclusion criteria | Definition† |
||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | ||
Any carbapenem‡ | NS | R | R | R | NS§ | R | ||||||
Any carbapenem (without ertapenem) | NS | NS | NS | R | NS | |||||||
>2 carbapenems‡ | NS§ | |||||||||||
All third-generation cephalosporins tested | R | R | ||||||||||
Any third-generation cephalosporins tested | R | R | ||||||||||
Cefepime | R | R | R |
*NS, nonsusceptible; R, resistant. Blank cells mean not included in the definition.
†Interpretation based on Clinical and Laboratory Standards Institute breakpoints (M100-S23) (11). Definitions: 1, nonsusceptible to any carbapenem, excluding ertapenem; 2, nonsusceptible to any carbapenem, excluding ertapenem, and resistant to all third-generation cephalosporins tested (pre-2015 Centers for Disease Control and Prevention carbapenem-resistant Enterobacteriaceae surveillance definition); 3, nonsusceptible to any carbapenem, excluding ertapenem, and resistant to any third-generation cephalosporins tested; 4, resistant to any carbapenem; 5, resistant to any carbapenem, excluding ertapenem; 6, resistant to any carbapenem and resistant to all third-generation cephalosporins tested; 7, resistant to any carbapenem and resistant to any third-generation cephalosporin tested; 8, nonsusceptible to at least 2 carbapenems (ertapenem resistant, if tested); 9, nonsusceptible to any carbapenem (ertapenem resistant, if tested) and resistant to cefepime; 10, resistant to any carbapenem and resistant to cefepime; and 11, nonsusceptible to any carbapenem, excluding ertapenem, and resistant to cefepime.
‡Ertapenem, doripenem, imipenem, and meropenem.
§If ertapenem used in the definition, isolate would need to be resistant (i.e., MIC >2 μg/mL).
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