Implementing carbapenem-resistance testing algorithms for Enterobacteriales and Pseudomonas aeruginosa: diagnostic and antimicrobial stewardship with timely infection prevention

Diagn Microbiol Infect Dis. 2020 Aug;97(4):115069. doi: 10.1016/j.diagmicrobio.2020.115069. Epub 2020 Apr 30.

Abstract

Early detection of carbapenem resistance in Gram-negative (CRGN) infections can help tailor therapy sooner and prevent horizontal transmission more efficiently. This involves timely, multidisciplinary communication. To this aim, we describe our experience with implementing reflex testing algorithms for expanded antibiotic susceptibilities and molecular mechanisms of resistance in a large academic hospital.

Keywords: Antimicrobial stewardship; Gram negative; Infection prevention; Microbiology; Resistance.

MeSH terms

  • Algorithms
  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Antimicrobial Stewardship
  • Carbapenems / pharmacology*
  • Carbapenems / therapeutic use
  • Clinical Laboratory Techniques
  • Drug Resistance, Bacterial / drug effects
  • Drug Resistance, Bacterial / genetics
  • Enterobacteriaceae / drug effects
  • Enterobacteriaceae / genetics
  • Enterobacteriaceae / isolation & purification
  • Gram-Negative Bacteria / drug effects*
  • Gram-Negative Bacteria / genetics
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Negative Bacterial Infections / diagnosis*
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / prevention & control
  • Humans
  • Middle Aged
  • Pseudomonas aeruginosa / drug effects
  • Pseudomonas aeruginosa / genetics
  • Pseudomonas aeruginosa / isolation & purification

Substances

  • Anti-Bacterial Agents
  • Carbapenems