SPICE organisms: Difference between revisions

Latest revision as of 14:44, 25 October 2024

Gram-negative bacteria with inducible or derepressable beta-lactamases, primarily AmpC β-lactamase

For Enterobacter cloacae, Klebsiella aerogenes, and Citrobacter freundii, avoid all penicillins and cephalosporins regardless of susceptibility testing
- Carbapenems still work, as do aminoglycosides
- Cefipime still works when MIC ≤2 mcg/mL
For Serratia marcescens, Morganella morganii, and Providencia, treat based on susceptibility testing
Less data for Hafnia alvei, Citrobacter youngae, and Yersinia enterocolitica, but reasonable to treat based on susceptibility testing

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 == Organisms ==
-* [[Serratia species]]
+* [[Serratia]]
 * [[Providencia]]
-* Indole-positive [[Proteus species]] (e.g. [[Proteus vulgaris]], but not [[Proteus mirabilis]])
+* Indole-positive [[Proteus]] (e.g. [[Proteus vulgaris]], but not [[Proteus mirabilis]])
-* [[Citrobacter species|'''Citrobacter species''']]
+* [[Citrobacter|'''Citrobacter''']]
-** [[C. koseri]] does ''not'' have an AmpC
+** [[Citrobacter koseri]] does ''not'' have an AmpC
 * [[Enterobacter cloacae|'''Enterobacter cloacae''']], and now also '''[[Klebsiella aerogenes]]''' (previously ''Enterobacter aerogenes'')
+* And maybe also:
+** [[Hafnia alvei]]
-Also:
+** [[Morganella morganii]]
-* [[Hafnia alvei]]
+** [[Cronobacter]]
+** [[Edwardsiella]]
-* [[Acinetobacter]], though not inducible or AmpC (merely very resistant_
-* [[Morganella morganii]]
-* [[Cronobacter]]
-* [[Edwardsiella]]
 == Management ==