The Practical Problem With Carbapenem Testing and Reporting Accurate Bacterial Susceptibilities

Area of Science:

• Microbiology
• Pharmacology
• Infectious Diseases

Background:

• Antibiotic resistance necessitates continuous evaluation of antimicrobial susceptibility breakpoints.
• Revised carbapenem breakpoints for Enterobacterales address rising resistance and optimize antibiotic exposure.
• Accurate identification of carbapenem resistance is vital for effective treatment.

Purpose of the Study:

• To examine the clinical and economic consequences of not using current carbapenem breakpoints.
• To identify barriers hindering the implementation of updated carbapenem susceptibility testing strategies.
• To propose actionable steps for adopting revised breakpoints.

Main Methods:

• A comprehensive literature review was performed.
• Searches were conducted in PubMed and Google Scholar databases.
• Data synthesis focused on real-world implications and implementation challenges.

Main Results:

• Non-adoption of revised breakpoints results in adverse clinical outcomes and elevated healthcare costs.
• Significant impediments exist for laboratories in updating and implementing new breakpoint guidelines.
• Barriers include technical, logistical, and educational challenges.

Conclusions:

• Implementing revised carbapenem breakpoints for Enterobacterales is essential for accurate susceptibility reporting.
• Addressing identified barriers is key to successful adoption by clinical laboratories.
• Clinicians rely on timely and accurate susceptibility data for optimal patient care.