How would testing for a carbapenemase impact the susceptibility test report?
Detecting a carbapenemase in the isolate of K. pneumoniae would indicate that the “susceptible” results for ertapenem, imipenem, meropenem, and the newly released doripenem, need to be interpreted with caution. These drugs may not be effective clinically, particularly for treating systemic infections like bacteremia. This is analogous to testing for ESBL-producing organisms that may yield MIC results for extended-spectrum cephalosporins in the susceptible range, even though those drugs will not be effective clinically. Thus, current methods for detecting carbapenem-resistant Enterobacteriaceae often lack sensitivity for detecting KPC and other carbapenemase producers and require the use of supplemental tests to improve detection.
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