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Carbapenem R x in infectionswith KPC KlebsiellaPatient Site MIC imipenem Days OutcomeVitek EtestimipenemM76 Respiratory 2 0.25 7-mero FailedM82 Blood 4 2 14 CureM92 Respiratory 4 2 3 CureF64 Respiratory 4 2 12 FailedF69 Respiratory 4 8 6 FailedF46 Blood 4 8 7 CureM77 Respiratory 4 >32 7 FailedF61 UTI 2 >32 7 CureM52 UTI 4 16 14 FailedF60 Blood >16 8 10-mero FailedM60 Respiratory >16 8 7-mero CureWeisenberg et al., DMID 2009;64:233
Which is more useful?48 h post-specimen‘It’s a Kleb. pneumoniae. Very resistant. We’ve found anMIC of 4 mg/L for meropenem, though. It might be okay athigh dose. Or prolonged infusion. Otherwise there’s colistin.’‘Yes of course; our lab is fully accredited!’4 h post-specimen‘There is something with a KPC gene in this sputum from MrX with the ventilator pneumonia’‘It’s likely to be resistant to everything except colistin’
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David Livermore - eucast

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