Table 2.
MIC Resistance Profile of Infections Treated With Imipenem-Cilastatin-Relebactam
| ID # | Index Organism(S) | MIC Resistance Profilea | ||
|---|---|---|---|---|
| 1 |
•\tProteus mirabilis
•\tPseudomonas aeruginosa •\tStaphylococcus aureus (MRSA) |
Pseudomonas:
Aztreonam-R Cefepime-I |
Ceftazidime-R
Ceftaz-Avi-S Cipro/Levo-R |
Gent/Tobra-S
Meropenem-I Pip-tazo-I(64) |
| 2 |
•\tProteus mirabilis
•\tPseudomonas aeruginosa •\tEnterococcus faecalis |
Pseudomonas:
Cefepime-S Ceftazidime-S Ceftaz-Avi(Etest)-S |
Ceftolo-tazo(Etest)-S
Cipro/Levo-R Gent/Tobra-S |
Imi-Rel-I(3)b,c Meropenem-R Pip-tazo-S |
| 3 |
•\tAchromobacter spp.
•\tPseudomonas aeruginosa |
Pseudomonas:
Amikacin-S Aztreonam-R Cefepime-R Cefiderocol(DD)-R Ceftazidime-R |
Ceftaz-Avi-R
Ceftolo-tazo-R Ceftriaxone-R Cipro/Levo-R Colistin-S Gent/Tobra-S |
Imipenem-S
Imi-Rel(Etest)-S2,3 Meropenem-R Mero-Vabor-S Pip-tazo-I |
| 4 | •\tPseudomonas aeruginosa |
Pseudomonas:
Amikacin-S Cefepime-R |
Ceftazidime-I
Ceftriaxone-R Cipro/Levo-R |
Meropenem-R |
| 5 | •\tPseudomonas aeruginosa |
Pseudomonas:
Amikacin-S Cefepime-I Ceftazidime-I |
Ceftaz-Avi-S
Ceftriaxone-R Gent/Tobra-S Imi-Rel-S2,3 |
Meropenem-I
Pip-tazo-I Polymyxin B-S |
| 6 | •\tPseudomonas aeruginosa |
Pseudomonas:
Amikacin-S Cefepime-I |
Ceftazidime-I
Ceftaz-Avi(Etest)-R Ceftriaxone-R |
Cipro/Levo-R
Gent/Tobra-S Meropenem-R |
| 7 | •\tPseudomonas aeruginosa |
Pseudomonas:
Amikacin(DD)-S Aztreonam(Etest)-R Cefepime(DD)-R |
Ceftazidime(DD)-R
Ceftaz-Avi(Etest)-R Cipro/Levo(DD)-R Colistin(Etest)-S |
Gent/Tobra(DD)-R
Imi-Rel(Etest)-S2,3 Meropenem(DD)-R Pip-tazo(DD)-S |
| 8 | •\tPseudomonas aeruginosa |
Pseudomonas:
Amikacin-S Aztreonam-R Cefepime-R Ceftazidime-R Ceftaz-Avi-R |
Ceftolo-tazo-R
Ceftriaxone-R Cipro/Levo-R Colistin-S Gent/Tobra-S |
1. Imipenem-S
2. Imipenem(Etest)-R Imi-Rel(Etest)-R2,3 Meropenem-R Mero-Vabor-R Pip-tazo-I |
| 9 | •\tPseudomonas aeruginosa |
Pseudomonas:
Ceftazidime-I |
Cipro/Levo-R
Gent/Tobra-S |
Imipenem-R |
| 10 | •\tPseudomonas aeruginosa |
Pseudomonas:
Cefepime-R |
Ceftazidime-R
Cipro/Levo-R |
Gent/Tobra-S
Imipenem-R |
| 11 | •\tPseudomonas aeruginosa |
Pseudomonas:
Cefepime-R Ceftazidime-R |
Cipro/Levo-R
Gent/Tobra-S |
Imipenem-R
Pip-tazo-R |
| 12 | •\tPseudomonas aeruginosa |
Pseudomonas:
Amikacin-S(16) Cefepime-R Ceftazidime-R |
Ceftaz-Avi(Etest)-R
Ceftriaxone-R Cipro/Levo-R Gent/Tobra-S |
Imipenem-R
Meropenem-R Mero-Vabor(Etest)-SDD Pip-tazo-R |
| 13 | •\tPseudomonas aeruginosa |
Pseudomonas:
Amikacin-I Aztreonam-R Cefepime-R |
Cefiderocol-S
Cipro/Levo-I Colistin(BMD)-I Gent-I/Tobra-S |
Imi-Rel(BMD)-S2,3 Meropenem-R Pip-tazo-R |
| 14 |
•\tPseudomonas aeruginosa
•\tStenotrophomonas maltophilia |
Pseudomonas:
Amikacin-S Cefepime-S(8) |
Ceftazidime-R
Ceftaz-Avi(Etest)-R Ceftriaxone-R |
Cipro/Levo-R
Gent/Tobra-S Meropenem-R |
| 15 |
•\tPseudomonas aeruginosa
•\tSerratia marcescens •\tAcinetobacter baumanii |
Pseudomonas:
Amikacin-S Aztreonam(DD)-R Ceftazidime-R Cefepime(DD)-R |
Cefiderocol(BMD)-S Cipro/Levo-R
Ceftolo-tazo-S Gent-I/Tobra-S |
Imipenem-R
Imi-Rel(Etest)-R2,3 Meropenem-R Pip-tazo(DD)-R |
| 16 |
•\tKlebsiella oxytoca
•\tPseudomonas aeruginosa •\tEnterococcus faecalis •\tGroup B Streptococcus |
Klebsiella
(ESBL+):
Aztreonam-R Ceftriaxone-R Cipro/Levo-S Gent/Tobra-S Meropenem-S Pip-tazo-R |
Pseudomonas:
Aztreonam-I Cefepime-S(8) Ceftazidime-S |
Cipro/Levo-R
Gent/Tobra-S Meropenem-I Pip-tazo-S |
| 17 |
•\tKlebsiella pneumoniae
•\tAcinetobacter baumanii •\tProteus mirabilis •\tStenotrophomonas maltophilia |
Klebsiella:
Amikacin-R Cefazolin-R Cefepime-SDD Cefiderocol(DD)-S Ceftazidime-I |
Ceftriaxone-R
Cipro/Levo-R Gent-S/Tobra-R Imipenem(Etest)-S Imi-Rel(Etest)-S2,3 |
Meropenem(Etest)-S
Minocycline(Etest)-I Pip-tazo-R Tetracycline-R |
| 18 |
•\tKlebsiella pneumoniae
•\tEnterococcus avium |
Klebsiella:
Amikacin-S(16) Cefazolin-R Cefepime-R Ceftazidime-R Ceftriaxone-R |
Ceftaz-Avi-S
Cipro/Levo-R Colistin-S Eravacycline-2 Ertapenem-R Gent-S/Tobra-R Imi-Rel-S2,3 |
Meropenem-R
Mero-Vabor-S Pip-tazo-R Tetracycline-R TMP/SMX-R |
| 19 |
•\tEnterobacter cloacae
•\tKlebsiella pneumoniae |
Enterobacter:
Amikacin-S Aztreonam(DD)-R Cefepime(DD)-R Ceftazidime-R |
Ceftaz-Avi(Etest)-R
Ceftriaxone-R Cipro/Levo-R Colistin(BMD)-S Gent/Tobra-S |
Imi-Rel(Etest)-S2,3 Meropenem-R Mero-Vabor(Etest)-S Tigecycline(DD)-R TMP/SMX-R |
| 20 |
•\tBurkholderia cepacia complex
•\tEnterobacter cloacae |
Burkholderia:
Cefiderocol(BMD)-0.25 Ceftazidime-S Ceftaz-Avi(BMD)-3 Cipro/Levo-R Imi-Rel(Etest)-22,3 Meropenem-I Minocycline-I TMP/SMX-R |
Enterobacter:
Amikacin-S Aztreonam-R Cefazolin-R Cefepime-I Cefiderocol(BMD)-S Cefpodoxime-R Ceftazidime-R |
Ceftaz-Avi-S
Cipro/Levo-S Gent/Tobra-S Imi-Rel(BMD)-S2,3 Meropenem-S Pip-tazo-R TMP/SMX-R |
| 21 | •\tEscherichia coli |
Escherichia:
Amikacin-S Cefepime-S Cefoxitin-R |
Ceftazidime-S
Ceftriaxone-S Cipro/Levo-R |
Gent/Tobra-S
Meropenem-S TMP/SMX-R |
Abbreviations: BMD, Broth Microdilution; CLSI, Clinical and Laboratory Standards Institute; DD, Disk Diffusion; ESBL, extended-spectrum β-lactamase; EUCAST, European Committee on Antimicrobial Susceptibility Testing; IMI/REL, imipenem-cilastatin-relebactam; MIC, minimum inhibitory concentration; R, resistant; S, susceptible; SDD, susceptible dose-dependent; TMP/SMX, trimethoprim/sulfamethoxazole.
CLSI breakpoints used for determinations of S, SDD, I, and R. Where I or SDD has multiple MIC breakpoints or MICs are significantly discrepant between CLSI and EUCAST, the specific MIC is listed in parentheses after the CLSI classification [31]. Parentheses after the antibiotic specify susceptibility method if not automated (ie, Disk Diffusion, Etest, or Broth Microdilution).
CLSI susceptibility breakpoints for IMI/REL are ≤1/4mg/L for Enterobacterales and ≤2/4 for P. aeruginosa. EUCAST breakpoints are ≤2/4 for P. aeruginosa and Enterobacterales.
For susceptibility testing purposes, the concentration of relebactam is fixed at 4mg/L.