SPICE organisms: Difference between revisions
From IDWiki
m (→�) |
No edit summary |
||
| (3 intermediate revisions by the same user not shown) | |||
| Line 9: | Line 9: | ||
* Indole-positive [[Proteus]] (e.g. [[Proteus vulgaris]], but not [[Proteus mirabilis]]) |
* Indole-positive [[Proteus]] (e.g. [[Proteus vulgaris]], but not [[Proteus mirabilis]]) |
||
* [[Citrobacter|'''Citrobacter''']] |
* [[Citrobacter|'''Citrobacter''']] |
||
** [[ |
** [[Citrobacter koseri]] does ''not'' have an AmpC |
||
* [[Enterobacter cloacae|'''Enterobacter cloacae''']], and now also '''[[Klebsiella aerogenes]]''' (previously ''Enterobacter aerogenes'') |
* [[Enterobacter cloacae|'''Enterobacter cloacae''']], and now also '''[[Klebsiella aerogenes]]''' (previously ''Enterobacter aerogenes'') |
||
* And maybe also: |
|||
** [[Hafnia alvei]] |
|||
Also: |
|||
| ⚫ | |||
* [[ |
** [[Cronobacter]] |
||
| ⚫ | |||
* [[Acinetobacter]], though not inducible or AmpC (merely very resistant_ |
|||
| ⚫ | |||
* [[Cronobacter]] |
|||
| ⚫ | |||
== Management == |
== Management == |
||
| Line 25: | Line 22: | ||
**[[Carbapenems]] still work, as do [[aminoglycosides]] |
**[[Carbapenems]] still work, as do [[aminoglycosides]] |
||
**[[Cefipime]] still works when MIC ≤2 mcg/mL |
**[[Cefipime]] still works when MIC ≤2 mcg/mL |
||
*For [[Serratia marcescens]], [[Morganella morganii]], |
*For [[Serratia marcescens]], [[Morganella morganii]], [[Providencia]], and [[Proteus]] treat based on susceptibility testing |
||
*Less data for [[Hafnia alvei]], [[Citrobacter youngae]], and [[Yersinia enterocolitica]], but reasonable to treat based on susceptibility testing |
*Less data for [[Hafnia alvei]], [[Citrobacter youngae]], and [[Yersinia enterocolitica]], but reasonable to treat based on susceptibility testing |
||
Latest revision as of 19:54, 7 February 2025
Background
- Gram-negative bacteria with inducible or derepressable beta-lactamases, primarily AmpC β-lactamase
Organisms
- Serratia
- Providencia
- Indole-positive Proteus (e.g. Proteus vulgaris, but not Proteus mirabilis)
- Citrobacter
- Citrobacter koseri does not have an AmpC
- Enterobacter cloacae, and now also Klebsiella aerogenes (previously Enterobacter aerogenes)
- And maybe also:
Management
- 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, Providencia, and Proteus treat based on susceptibility testing
- Less data for Hafnia alvei, Citrobacter youngae, and Yersinia enterocolitica, but reasonable to treat based on susceptibility testing
Further Reading
- Jones R, Baquero F, Privitera G, Inoue M, Widermann B. Inducible β-lactamase-mediated resistance to third-generation cephalosporins. Clin Microbio Infect. 1997;3(1):S7-S20.
- https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciz173/5369903
