M141-4

Midstream Urine: Klebsiella pneumoniae (KPC producer)  – Shipped May 2014

HISTORY

The challenge was a simulated midstream urine obtained from a 56 year old male patient from Montreal with flank pain and was sent to cate-gory A laboratories.

Laboratories were expected to isolate, identify, and report Klebsiella pneumoniae. Participants were asked to report susceptibility results to the following antimicrobial agents: 3rd generation cephalosporins, carbapenems, aminoglycosides, trimethoprim-sulfamethoxazole (SXT), piperacillin-tazobactam, and ciprofloxacin. Laboratories were also expected to report the isolate to Infection Control because it is a carbapenem-resistant Enterobacteriaceae (CRE).

MAIN EDUCATIONAL POINTS from M141-4

  1. Carbapenemase-producing Enterobacteriaceae (CPE) are frequently multi-drug resistant and require expanded antimicrobial susceptibility testing.
  2. Clinical laboratories need to be able to identify carbapenem-resistant Enterobacteriaceae (CRE) and have an established pro-cedure to determine if these isolates are CPE. Potential isolates of CPE (i.e., CRE) should be reported to Infection Control.

Full critique (PDF)

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