Microbiology C&S
Culture sensitivity reports — antimicrobial susceptibility testing and stewardship guidance
ESBL Klebsiella detected (MIC-2026-0441 / Rajan Mehta ICU-1) — CRITICAL alert. Contact prescribing team immediately. Review antibiotic cover.
Rajan Mehta, 75M
MIC-2026-0441 · Tracheal aspirate · Collected 20 Jun 2026 06:00 · Dr. R. Iyer
VAP (Ventilator-associated pneumonia) — fever + purulent secretions day 5 post-CABG
ESBL+
Organism: Klebsiella pneumoniae — ESBL producing
Colony Count: Heavy growth — > 10⁵ CFU/mL
Gram Stain: Gram-negative bacilli — plentiful
Antibiogram
| Antibiotic | Result | MIC |
|---|---|---|
| Meropenem | Sensitive | ≤ 0.25 µg/mL |
| Imipenem | Sensitive | ≤ 0.5 µg/mL |
| Colistin / Polymyxin B | Sensitive | ≤ 0.5 µg/mL |
| Tigecycline | Sensitive | ≤ 1 µg/mL |
| Piperacillin-Tazobactam | Resistant | > 128 µg/mL |
| Ceftriaxone | Resistant | > 64 µg/mL |
| Cefuroxime | Resistant | > 32 µg/mL |
| Ciprofloxacin | Resistant | > 4 µg/mL |
| Gentamicin | Intermediate | 8 µg/mL |
| Amikacin | Sensitive | 4 µg/mL |
| Cotrimoxazole | Resistant | > 32 µg/mL |
ESBL-producing Klebsiella pneumoniae (VAP). Carbapenems are the drug of choice. Recommend: Meropenem 1g IV TDS. If pan-resistant, consider Colistin + Meropenem combination. Antibiotic stewardship: de-escalate to narrowest effective agent when clinical improvement confirmed. Duration: 8 days for VAP (HAP guidelines).