Вы находитесь на странице: 1из 7

Singapore Society of Pathology

Slides &
Society of Infectious Diseases, Singapore

Pictures and text provided


courtesy of:
Dr. Koh Tse Hsien
Singapore General Hospital Antimicrobial
Susceptibility
Testing
Sponsors:

We gratefully acknowledge the


support of the following
organisations:

Faculty members
Department of Pathology,
Dr. Koh Tse Hsien Singapore General Hospital,
Dr. Nancy Tee
Mr. Lim Tze Peng 21-23rd September 2010,
Dr. Jaime Chien
Dr. Tan Thean Yen We also acknowledge support from the Singapore
Ms. Lily Ng Siew Yong following companies:
Ms. Tan Peck Lay
Ms. Irene Tan Siemens Healthcare Diagnostics Pte Ltd
organised in conjunction with
Klebsiella producing DMA plasmid AmpC beta-lactamase. IPI: Imipenem+MBL (metallo-beta-lactamase) inhibitor
(EDTA), IP: Imipenem
There is some non-specific decrease in imipenem MIC in the presence of the inhibitor but not as dramatic as what you
will see with a true MBL producer. DHA is a class C enzyme that is inhibited by boronic acid and cloxacillin.
Klebsiella pneumoniae KPC ATCC control strain. There is no significant fall of imipenem in the presence of MBL
inhibitor. This is becase KPC is a class A enzyme that is inhibited by clavulanic acid
Klebsiella class B metallo-beta-lactamase (NDM-1) producer. There is a dramatic decrease in imipenem MIC in the
presence of inhibitor. The inhibitor (EDTA) is a metal chelator that prevents zinc ions from reaching the active site of the
enzyme.
Clockwise from bottom right. Meropenem; Meropenem + Boronic acid; Meropenem +Cloxacillin; Meropenem +EDTA
Klebsiella plasmid AmpC DHA producer. Class C enzymes are inhibited by boronic acid and cloxacillin. This strain also
shows some non-specific inhibition with EDTA.
Clockwise from bottom right. Meropenem; Meropenem + EDTA; Meropenem +Cloxacillin; Meropenem +boronic acid
Klebsiella plasmid ATCC KPC control. KPC enzymes are only inhibited by boronic acid
Clockwise from bottom right. Meropenem; Meropenem + boronic acid ; Meropenem +Cloxacillin; Meropenem +EDTA.
Klebsiella metallo-beta-lactamase NDM-1 producer. There is a large zone of inhibition around the meropenem disk with
added EDTA indicating the presence of a MBL. There is also a suggestion of inhibition around the meropenem disk with
added boronic acid. This strain produced both NDM-1 MBL and CMY and DHA plasmid AmpC enzymes-but the MBL is
swamping the effects of the plasmid AmpC so that the AmpC phenotype is not seen.

Вам также может понравиться