{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T15:37:34Z","timestamp":1769441854227,"version":"3.49.0"},"reference-count":20,"publisher":"American Society for Microbiology","issue":"1","license":[{"start":{"date-parts":[[2015,1,1]],"date-time":"2015-01-01T00:00:00Z","timestamp":1420070400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            The Clinical and Laboratory Standards Institute (CLSI) lowered the MIC breakpoints for meropenem and imipenem from 4 mg\/liter to 1 mg\/liter for\n            <jats:named-content content-type=\"genus-species\">Enterobacteriaceae<\/jats:named-content>\n            in 2010. The breakpoint change improves the probability of pharmacodynamic target attainment and eliminates the need for microbiology labs to perform confirmatory testing for\n            <jats:named-content content-type=\"genus-species\">Klebsiella pneumoniae<\/jats:named-content>\n            carbapenemase (KPC) production or other beta-lactamases that hydrolyze carbapenems. However, there are limited data evaluating clinical outcomes of the affected breakpoints, and it is unknown if patients infected with\n            <jats:named-content content-type=\"genus-species\">Enterobacteriaceae<\/jats:named-content>\n            with reduced susceptibility are more likely to have poor outcomes when treated with a carbapenem. We conducted a single-center retrospective matched-cohort analysis in adult patients with\n            <jats:named-content content-type=\"genus-species\">Enterobacteriaceae<\/jats:named-content>\n            infections treated with meropenem, imipenem, or doripenem. Patients with\n            <jats:named-content content-type=\"genus-species\">Enterobacteriaceae<\/jats:named-content>\n            infection with a carbapenem MIC of 2 to 8 mg\/liter were matched based on pathogen, source of infection, comorbidities, and disease severity (1:1 ratio) to those with a carbapenem MIC of \u22641 mg\/liter. A total of 36 patients were included in the study. The group with carbapenem MICs of 2 to 8 mg\/liter had a significantly higher 30-day mortality than the group with carbapenem MICs of \u22641 mg\/liter (38.9% compared to 5.6%,\n            <jats:italic>P<\/jats:italic>\n            = 0.04). Total hospital length of stay (LOS) and intensive care unit (ICU) LOS were longer in the group with MICs of 2 to 8 mg\/liter than in the group with MICs of \u22641 mg\/liter (57.6 days compared to 34.4 days [\n            <jats:italic>P<\/jats:italic>\n            = 0.06] and 56.6 days compared to 21.7 days [\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.01], respectively). Patients infected with\n            <jats:named-content content-type=\"genus-species\">Enterobacteriaceae<\/jats:named-content>\n            with a carbapenem MIC of 2, 4, or 8 mg\/liter had higher mortality rates and longer ICU LOS than matched cohorts with carbapenem MICs of \u22641 mg\/liter, which supports CLSI's recommendation to lower susceptibility breakpoints for carbapenems.\n          <\/jats:p>","DOI":"10.1128\/jcm.03057-14","type":"journal-article","created":{"date-parts":[[2014,11,7]],"date-time":"2014-11-07T08:20:55Z","timestamp":1415348455000},"page":"201-205","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":47,"title":["Clinical Outcomes of Enterobacteriaceae Infections Stratified by Carbapenem MICs"],"prefix":"10.1128","volume":"53","author":[{"given":"Twisha S.","family":"Patel","sequence":"first","affiliation":[{"name":"Departments of Pharmacy Services and Clinical Sciences, University of Michigan Health System and College of Pharmacy, Ann Arbor, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerod L.","family":"Nagel","sequence":"additional","affiliation":[{"name":"Departments of Pharmacy Services and Clinical Sciences, University of Michigan Health System and College of Pharmacy, Ann Arbor, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1086\/502306"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2009.08.020"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1086\/499819"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1086\/595011"},{"key":"e_1_3_1_6_2","volume-title":"M100-S119","author":"Clinical and Laboratory Standards Institute","year":"2009","unstructured":"Clinical and Laboratory Standards Institute. 2009. Performance standards for antimicrobial susceptibility testing. M100-S119. Clinical and Laboratory Standards Institute, Wayne, PA."},{"key":"e_1_3_1_7_2","volume-title":"M100-S120","author":"Clinical and Laboratory Standards Institute","year":"2010","unstructured":"Clinical and Laboratory Standards Institute. 2010. Performance standards for antimicrobial susceptibility testing. M100-S120. Clinical and Laboratory Standards Institute, Wayne, PA."},{"key":"e_1_3_1_8_2","volume-title":"Abstr 44th Intersci Conf Antimicrob Agents Chemother","author":"Ambrose PG","year":"2004","unstructured":"Ambrose PG, Bhavnani SM, Jones RN, Craig WA, Dudley MN. 2004. Use of pharmacokinetic-pharmacodynamic and Monte Carlo simulation as decision support for the reevaluation of NCCLS cephem susceptibility breakpoints for Enterobacteriaceae, abstr A-138. Abstr 44th Intersci Conf Antimicrob Agents Chemother. ASM, Washington, DC."},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2005.09.011"},{"key":"e_1_3_1_10_2","volume-title":"Abstr 45th Intersci Conf Antimicrob Agents Chemother. ASM","author":"Craig WA","year":"2005","unstructured":"Craig WA, Bhavnani SM, Ambrose PG, Dudley MN, Jones RN. 2005. Evaluation of clinical outcomes among patients with ESBL producing Enterobacteriaceae treated with cephalosporin monotherapy, abstr K-1291. Abstr 45th Intersci Conf Antimicrob Agents Chemother. ASM, Washington, DC."},{"key":"e_1_3_1_11_2","unstructured":"The European Committee on Antimicrobial Susceptibility Testing. 2014. Breakpoint tables for interpretation of MICs and zone diameters. Version 4.0. http:\/\/www.eucast.org\/fileadmin\/src\/media\/PDFs\/EUCAST_files\/Breakpoint_tables\/Breakpoint_table_v_4.0.pdf."},{"key":"e_1_3_1_12_2","volume-title":"January 2010 meeting presentation: Enterobacteriaceae WG report","author":"Clinical and Laboratory Standards Institute","year":"2010","unstructured":"Clinical and Laboratory Standards Institute. 2010. January 2010 meeting presentation: Enterobacteriaceae WG report. Clinical and Laboratory Standards Institute, Wayne, PA."},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1086\/592412"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01487-06"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1086\/528712"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00580-08"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.06365-11"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03553.x"},{"key":"e_1_3_1_19_2","volume-title":"Abstr 50th Intersci Conf Antimicrob Agents Chemother. ASM","author":"Bhavnani SM","year":"2010","unstructured":"Bhavnani SM, Dudley MN, Landersdorfer L, Drusano GL, Craig WA, Jones RN, Ambrose PG. 2010. Pharmacokinetic-pharmacodynamic basis for CLSI carbapenem susceptibility breakpoint changes, abstr A-1382. Abstr 50th Intersci Conf Antimicrob Agents Chemother. ASM, Washington, DC."},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.49.5.1881-1889.2005"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2010.06.012"}],"container-title":["Journal of Clinical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/JCM.03057-14","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/JCM.03057-14","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,5]],"date-time":"2022-03-05T12:13:13Z","timestamp":1646482393000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/JCM.03057-14"}},"subtitle":[],"editor":[{"given":"G. V.","family":"Doern","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2015,1]]},"references-count":20,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2015,1]]}},"alternative-id":["10.1128\/JCM.03057-14"],"URL":"https:\/\/doi.org\/10.1128\/jcm.03057-14","relation":{},"ISSN":["0095-1137","1098-660X"],"issn-type":[{"value":"0095-1137","type":"print"},{"value":"1098-660X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,1]]},"assertion":[{"value":"2014-10-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-10-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-12-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}