Osteomyelitis due to the S anginosus group is uncommonly reported. Our case series illustrates the virulence of these organisms in the context of osteomyelitis and the importance of aggressive management.

No abstract

No abstract

96% prevalence of the KPC enzyme among all carbapenemases in the United States was reported, and the KPC enzyme was most commonly acquired by Klebsiella pneumoniae [7]. Luckily, several new combination beta-lactams utilizing novel beta-lactamase inhibitors have been FDA approved in the United States to combat Class A carbapenemases, notably ceftazidime-avibactam and meropenem-vaborbactam. Class B enzymes, or metallo-beta-lactamases (MBLs), are more globally distributed outside of the Unites States. They are characterized by the New Delhi metallo-betalactamase (NDM) endemic to India, Verona integrinencoded metallo-beta-lactamase (VIM) found in Europe, and imipenemase metallo-beta-lactamase (IMP) in Asia and Australia [8]. These carbapenemases are very difficult to treat, as antimicrobial options are limited. To date in the United States, only older antimicrobials such as polymyxins, aminoglycosides, or glycylcyclines are available. As noted above, Class C enzymes, commonly known as cephalosporinases, do not confer carbapenem resistance are not discussed in this article. Lastly, Class D enzymes are caused by a variety of oxacillinase beta-lactamases (OXA) and are endemic in northern Africa, eastern Europe, and India. An example is the oxacillinase (OXA) enzyme subtype. CRE Laboratory Detection Accurate laboratory detection of carbapenemases is essential to optimize patient care and facilitate timely infection control prevention measures. In the United States, CRE isolates are reportable to state health departments, with further tracking by the CDC. Laboratories have faced challenges with accurately identifying isolates. Some isolates tested susceptible to carbapenems, however, carbapenem MICs were elevated. In addition, some automated susceptibility testing systems failed to detect low-level carbapenem resistance. In 2010, the Clinical and

No abstract

No abstract

No abstract