Table 1.
Definition criteria and antibiotic panel for Enterobacterales (Escherichia coli, Klebsiella pneumoniae and Enterobacter sp.)
| Antimicrobial category | ECDC-MDR | KRINKO-3MRGN | KRINKO-4MRGN | UHZ-MDR |
|---|---|---|---|---|
| Antipseudomonal penicillins | Piperacillin/ tazobactam or ticarcillin/ clavulanic acid | Piperacillin a) | Piperacillin a) | Piperacillin/ tazobactam |
| Extended spectrum cephalosporins | Cefotaxime or ceftriaxone or ceftazidime or cefepime | Cefotaxime b) or ceftazidime | Cefotaxime b) or ceftazidime | Ceftriaxone and ceftazidime and cefepime |
| Carbapenems | Ertapenem or imipenem or meropenem or doripenem | Imipenem or meropenem | Imipenem or meropenem | ≥ 2 of: Ertapenem, imipenem, meropenem |
| Quinolones | Ciprofloxacin | Ciprofloxacin | Ciprofloxacin | Ciprofloxacin and levofloxacin |
| Aminoglycosides | Amikacin or gentamicin or tobramycin or netilmicin | ≥2 of: Amikacin, gentamicin, tobramycin | ||
| Monobactams | Aztreonam | |||
| Phosphonic acids | Fosfomycin | |||
| non-extended spectrum cepholosporins | Cefazolin c) or cefuroxime | |||
| anti-MRSA cephalosporins e) | Ceftaroline | |||
| Cephamycins | Cefoxitin c) or Cefotetan c) | |||
| Folate pathway inhibitors | Trimethoprim/ sulphamethoxazol | |||
| Glycylcyclines | Tigecycline | |||
| Penicillins | Ampicillin c) d) | |||
| Penicillins plus beta-lactamase-inhibitors | Amoxicillin/ clavulanic acid c) or ampicillin/ sulbactam c) | |||
| Phenicols | Chloramphenicol | |||
| Polymyxins | Colistin or polymyxin B | |||
| Tetracyclines | Tetracycline or doxycycline or minocycline | |||
| Definition of MDR | Resistant to ≥3 categories | Resistant to antipseudomonal penicillin and cephalosporin-group and quinolone and susceptible to carbapenems | Resistant to all 4 categories or if a carbapenem is resistant all Enterobacterales are interpreted as 4MRGN or Enterobacterales with carbapenemase production | Resistant to 3 out of 5 categories or ESBL-producing Enterobacterales (except E.coli) or Enterobacterales with carbapenemase production |
Abbreviations: ECDC-MDR Multidrug resistance according to the European Centre for Disease Prevention and Control, KRINKO-3MRGN Multidrug resistance to three antibiotic categories according to the German Commission of Hospital Hygiene and Infection Prevention, KRINKO-4MRGN Multidrug resistance to four antibiotic categories according to the German Commission of Hospital Hygiene and Infection Prevention, MDR Multidrug resistant, UHZ-MDR Multidrug resistance according to University Hospital Zurich guidelines
a) as piperacillin/tazobactam and not piperacillin was tested: Resistance to ceftriaxone and/or ceftazidime was interpreted as resistance to Piperacillin [21]
b) as cefotaxime was not tested, ceftriaxone replaces cefotaxime
c) intrinsic resistance of Enterobacter claocae and Enterobacter aerogenes
d) intrinsic resistance of Klebsiella
e) only approved for E. coli, K. pneumoniae and K. oxytoca
Italic font: not tested in UHZ or only tested by MIC under special circumstances