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We currently do not perform anaerobe susceptibilities routinely but we call the physician when we isolate an anaerobe from a blood or critical source. The phone call seems to prompt a "yes" answer regardless of what the anaerobe is. Are there some anaerobes where, even when isolated from a critical source, susceptibilities need not be performed? (answered 06/21/2007) |
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Should susceptibility testing be performed on organisms (e.g. S. aureus)isolated from different specimen sources from the same patient that were collected on the same day? (answered 06/17/2007) |
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Should susceptibilities be performed on Group B Beta Strept. in a Urine culture of significant amount? (answered 06/15/2007) |
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How is the modified Hodge test performed & interpreted? (answered 06/15/2007) |
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How likely is it that the MicroScan has incorrectly ID'd Aerococcus viridans from a urine culture? It was the only organism ID'd and the patient was symptomatic and reides in a nursing home. Levofloxacin was used to treat. Was it Aerococcus viridans? It's the first i've seen in 7 + years of reading the antibiograms. (answered 06/08/2007) |
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Would the MicroScan instrument ID a VRSA if it were not? For instance, a wound culture from a patient in a nursing home is ID'd as VRSA by the instrument when reading the susceptibility panel. Is it likely to have been an instrument error? It was not recognized as significant at the time by the tech and there was no follow-up, reset, etc. Eastern USA, Ohio. (answered 06/08/2007) |
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Is it necessary or helpful to perform routine susceptability testing on Haemophilus isolated from respiratory specimens? Is there helpful text information that can be added to the report to guide the physician in appropriate treatment? (answered 05/30/2006) |
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While doing our antibiogram for 2006, we noticed on the Microscan that E.coli was only sensitive to Amp/Sulbactam 61% but sensitive to Augmentin 90%. We found that another local hospital had similar results. What causes that difference? (answered 05/26/2007) |
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We perform only disc diffusion method of ABST in our lab.we tend to get isolates of pneumococci that exhibit resistance to oxacillin but are susceptible to penicillin and cephalosporins. How should we send the sensitivity report? What comment should we add in the report? We do not do MIC testing in the lab. (answered 05/17/2007) |
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what are the current CLSI guidelines for screening for ESBL production amongst Pseudomonas and Acinetobacter? (answered 05/15/2007) |
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When a panel on our Microscan flags a sensitivity as a possible ESBL, we do confirmatory tests. If the result is negative for ESBL, should we be confirming for Amp C?? any help would be appreciated. thanks (answered 05/08/2007) |
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what do you do to confirm carbapenem resistance in automated system (answered 04/13/2007) |
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Do I have to test Staph aureus with Cefoxitin disks? I use Microscan for MIC's and an Oxacillin screen agar to confirm Methicillin resistance. I do NOT report Oxacillin results on Staph epid or any coag neg Staph. We don't feel it is difficult to read and if that is the only reason to change, must I?? (answered 04/10/2007) |
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should sensitivity be performed on group a beta strep from a wound culture? (answered 04/03/2007) |
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Can growth from a Kirby Bauer plate (or Etest plate) be used to make the inoculum to set additional disks or strips? Occasionally, for who knows what reason, the only 18 -24 hours old plate of isolate available is the Kirby or etest Mueller-Hinton. I'm uncomfortable when I see this plate being used for more testing. Am I being to cautious? (answered 03/29/2007) |
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I am in need of a book on antimicrobials and resistance patterns in bacteria that is pertinent to the clinical microbiologist. Could you recommend a book please? (answered 03/26/2007) |
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Currently our lab performs an OXOID test (for PBP2a) and a BHI-vancomycin screen on all S. aureus isolates. We are currently using the Vitek GP 61 card and are getting ready to switch to the GP 66 card. Since this card has both the cefoxitin screen and the vacomycin screen, can we discontinue using the OXOID and the BHI-vancomycin plates? (answered 03/22/2007) |
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What are your recommendations for performing QC by Disk Diffusion Kirby Bauer method? Should it be perfomed weekly or bi-weekly? (answered 03/20/2007) |
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guidelines for when to perform beta lactamase on staphs and enterococci (answered 03/12/2007) |
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If High-level AmpC production has minimal effect on the activity of cefepime, making this drug a more reliable agent for ESBL detection in the presence of an AmpC enzyme. Is reliable the routine application of the new Etest strip based on clavulanate synergy with cefepime to report esbl + for Enterobacter sp? (answered 03/05/2007) |
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We use ETEST strips for susceptibility testing on request for Strep species. How do you interpret the MIC when the etest concentrations do not coincide with CLSI breakpoints? (ex. a Strep sp. (not S. pneumo) has growth either up to the 0.125 concentration or between 0.094 and 0.125 (which we would round to up). The CLSI breakpoints are <=0.12 sus and 0.25-2 intermediate. (answered 02/28/2007) |
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We report MICs for clindamycin and erythromycin on Group B strep on penicillin allergic maternity patients. The lowest dilution well for erythromycin on our current microscan panel is 0.5, but the CLSI breakpoints are <=0.25 sus and 0.5 intermediate. Any suggestions for reporting or extra testing on isolates with an erythromycin MIC of <=0.5 (99% of our isolates)? (answered 02/28/2007) |
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What are the current guidelines regarding using Enterococcus faecalis to quality control Mueller Hinton agar for thymidine content.? (answered 02/27/2007) |
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DOES STAPH AUREUS WITH PENICILLIN <=0.03 NEED TO HAVE BETA LACTAMASE PERFORMED? (answered 02/23/2007) |
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ESBL: M100-S17 states that all pens, cephs, and aztreo should be reported as resistant for confirmed ESBL positive enterics. What's not clearly stated is how to report pen/inhibitor combination drugs for ESBL positive orgs. Looking for some guidance. Thank you. Richard Dern, St Marys Hosp, Madison WI (answered 02/09/2007) |
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What is the standard zone of inhibition of meropenem against pseudomonas? If a Pseudomonas isolate is sensitive to imipenem but resistant to meropenem, do I still go ahead and test for metallobetalactamase production? (answered 02/08/2007) |
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should testing for both cefoxitin and oxacillin on all staphylococci be routine? How we differentiate between cefoxitin-susceptoble, mec-A negative and oxacillin resistant isolates, if automate susceptibility testing gives you break-point values, not true MIC? Will fox-s, oxa-r isolates grow on oxacillin screen agar? (answered 02/08/2007) |
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Guidelines for Susceptibilities for B. cat (answered 02/06/2007) |
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Is it still recommended to follow the Cascade of Cepholosporins for gram negative sensitivities? (answered 02/06/2007) |
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Are there any guidelines for detecting or reporting potential inducible amp c in gram negative bacteria (answered 02/06/2007) |
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We are receiving requests to look for heteroresistant subpopulations of S. aureus with reduced susceptibility to vancomycin (hVISA. We use the macro-Etest method with a 2.0 McFarland suspension/200 ul on a BHI plate. If we see colonies growing in the vancomycin inhibition zone at 8 mg/L, the test is positive. But results should be confirmed with population analysis profiles (PAP-AUC ratios) by a reference lab. We are trying to see what % of our S. aureus strains test positive. Are other labs doing this test? If a patient is not doing well on vancomycin it would seem to make sense to switch to another drug, such as daptomycin or linezolid, regardless of whether we can find a vancmycin resistant subpopulation. (answered 02/05/2007) |
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According to M100-S17 CLSI document there is interpretive criteia for colistin when testing Pseudomonas. Can I use these when testing Acinetobacter or should I continue with FDA guidelines and append the comment not CLSI standardized? If I connot use the interpretive criteria for Acinetobacter, should I use CLSI QC guidelines or continue using package insert FDA interps? (answered 02/01/2007) |
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Are we still required to set up a van. screen for Enterococcus species if we use MicroScan ID panels? (answered 01/29/2007) |
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We have recently had 2 isolates of E.coli that were reported as ESBL positive by the Vitek 2. However, the Vitek did not change the interpretations for aztreonam, ceftazidime, & cefepime (it reported these as susceptible.) When we repeated the Vitek, we obtained the same results. We do not have any other ESBL confirmatory available. Should we trust the positive Vitek ESBL result, and change the interpretations to resistant manually? (answered 01/16/2007) |
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One of our ID Docs want to know why we are doing AST for CNS when they use vanco routinely and most others are R anyway? Thanks (answered 12/07/2006) |
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Since the current CLSI(NCCLS) M11-A6 document states that the Micro Broth Dilution technique can only be used to test susceptibility for B fragilis Group organisms, what does a small community hospital do when other anaerobes grow from sterile sites and a sens needs to be done? Our reference lab only offers a broth dilution MIC, and to send an organism out means a 2-4 day wait for results.Will the new CLSI Anaerobe susceptibility document allow for more organisms to be tested with the broth dilution method? (answered 12/06/2006) |
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Should susceptibility testing be done on a heavy growth of Staphylococcus aureus recovered from wound swab specimens that have no polymorphonuclear wbc in the gram smear? (answered 12/05/2006) |
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I am currently doing a research about detection of MRSA in a hospital. I've read that Cefoxitin Disk Diffusion Test is the best test for detecting MRSA.I wanted to perform it but I am not familiar with the procedure of Cefoxitin Disk Diffusion Test. What should I do? (answered 12/03/2006) |
