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M193-4

Posted on by Caleb Lee

Abdominal Abscess: Escherichia coli OXA48-like carbapenemase producer  – Shipped on November 4, 2019 FINAL RESULT

HISTORY

A simulated abdominal abscess swab, collected from a 42-year-old patient with a right lower quadrant intraabdominal abscess, was sent to
category A laboratories.
Participants were expected to isolate and identify Escherichia coli (OXA-48-like carbapenemase producer)

MAIN EDUCATIONAL POINTS from M193-4

  1. Carbapenemase-producing organisms are becoming increasingly common globally, including in Canada. Laboratories must be ready to detect, communicate, and confirm these isolates, especially in Enterobacterales/Enterobacteriales
  2. The most sensitive characteristic for detection of carbapenemase-producing Enterobacterales is ertapenem non-susceptibility. Routine susceptibility testing of isolates producing some carbapenemases, including OXA-48-like enzymes, may only flag as ertapenem I/R. It is important to follow these organisms up with further testing to determine their carbapenemase status.

Full critique (PDF)

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