April 26, 2021 Microbiology Lab Updates

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VOL. 44, NO. 3 – April 26, 2021 Microbiology Lab Updates Thomas Novicki PhD D( ABMM), Clinical Scientist, Microbiology Effective date: March 24, 2021 Following discussions with our infectious diseases specialists and the antimicrobial stewardship committee, we will make these changes to the testing and reporting of antimicrobial agents: 1. Discontinue routinely reporting ertapenem. This drug will be available upon request to the Microbiology lab. INSIDE THIS ISSUE 2. Due to the tendency for the Citrobacter freundii complex, Microbiology Lab Updates Enterobacter cloacae complex, Hafnia alvei & Klebsiella Changes to testing and reporting (Enterobacter) aerogenes to develop resistance to ampicillin of antimicrobial agents .............. 1 st rd and 1 – 3 generation cephalosporins during treatment with these drugs we will do the following for these species: a) Always report ampicillin, amoxicillin/ clavulanic acid, cefazolin, ceftriaxone & ceftazidime as Resistant. b) Add the following comments: i. Blood isolates: “Treatment failures have occurred with use of cefepime and piperacillin/tazobactam. Consultation with an Infectious Diseases specialist is recommended.” ii. Isolates from all other sources: “Treatment failures have occurred with use of cefepime and piperacillin/tazobactam. Repeat cultures in 3-4 days may therefore be warranted.” 3. Return to performing micro-broth dilution antimicrobial susceptibility testing for non-fermenting Gram negative bacilli (e.g. Burkholderia cepacia complex, Stenotrophomonas maltophilia) in-house using micro-broth dilution MIC methodology. (This testing had been temporarily directed to our reference lab due to a technical limitation.) Please feel free to contact me, an infectious diseases specialist, or Logan Whitfield, Pharm. D. with questions about these changes. .

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