Dropping the MIC; Review of the Updated Breakpoints -- Melissa Albert, PharmD

Melissa Albert, Infectious Diseases Pharmacy Resident, discusses the recent new literature regarding changes in the clinical breakpoints. Utilizing clinical cases, Dr. Albert demonstrates how to interpret antimicrobial susceptibility reports as well as how to design a patient-centered treatment regimen. Dr. Albert also discusses inducible AmpC-E resistance and how specific breakpoints have been changed for Aminoglycosides.
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[@blessingjames911]

08:33 kindly clarify please. i thought the break point is the minimal inhibitory concentration (MIC) or zone diameter value used to categorize an organism as susceptible, susceptible-dose dependent, intermediate, resistant, or nonsusceptible. Your definition of breakpoint is different. thank you

[@blessingjames911]

17:30 could this isolate also harbour ampC? even though not a common resistance mechanism in E.coli compared to ESBL, E.coli can also be an ampC producer and given that this isolate is resistant to the third genereation cephalospsorins and susceptible to cefepime could that be inferred?. plus other resistance mechanisms maybe at play. ps the lab did report a negative screen for esbl. is the report not reliable?

[@ccbowers]

15:26 Klebsiella is a genus, not species. So they are the same genus, but different species. It's probably worth pointing out that klebsiella aerogenes was previously (and fairly recently) described as enterobacter aerogenes, so much of the literature has it described as such