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Algorithm for detection of classical ESBL (ESBL A )

CTX I/R eller CAZ I/R. E. coli, K. pneumoniae, P. mirabilis, Salmonella spp., Shigella spp. K. oxytoca, P. vulgaris, C. koseri. Övriga Enterobacteriaceae. ESBL A -test (klavulansyra). Kromosomal betalaktamas. Oftast kromosomal betalaktamas. Positiv: ESBL A. ESBL A -test endast

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Algorithm for detection of classical ESBL (ESBL A )

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  1. CTX I/R eller CAZ I/R E. coli, K. pneumoniae, P. mirabilis, Salmonella spp., Shigella spp. K. oxytoca, P. vulgaris, C. koseri Övriga Enterobacteriaceae ESBLA-test (klavulansyra) Kromosomal betalaktamas Oftast kromosomal betalaktamas Positiv: ESBLA ESBLA-test endast Om CAZ R ESBLA-test om resistent mot ≥ 2 icke-betalaktamer Negativ: gör ESBLM- test Algorithm for detection of classical ESBL (ESBLA)

  2. ESBLA-negativa E. coli, K. pneumoniae, P. mirabilis, Salmonella spp, Shigella spp Positiv AmpC-test Negativ AmpC-test E. coli och Shigella spp: PCR bör utföras för att skilja plasmid- och kromosomalt medierad AmpC K.pneumoniae, P.mirabilis, Salmonella saknar kromosomalt AmpC och har plasmidmedierad AmpC Annan resistens (porin-förlust, PBP-förändringar) Algorithm for detection of AmpC (ESBLM)

  3. Algorithm for detection of carbapenemases (ESBLCARBA)

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