Should imipenem-resistant Proteus spp. be referred for testing ?
Not usually. This genus is least susceptible of the Enterobacteriaceae to imipenem, with MICs hovering around the breakpoint (4 mg/L). Hence some isolates may have low-level imipenem resistance, while retaining susceptibility to meropenem and ertapenem. Any isolates of Proteus spp. displaying resistance to meropenem or ertapenem should be submitted for confirmation and possible investigation of resistance mechanisms, as should any with high-level imipenem resistance (MIC >16 mg/L).
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