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<t>CZA-heteroresistant</t> strains and stability of their resistant subpopulations among the 25 clinical carbapenem-resistant Klebsiella pneumoniae isolates. ( A ) <t>Satellite</t> <t>colonies</t> in the CZA E-test strip for the CRKP11, CRKP19, and CRKP26 strains. ( B ) Population analysis profiles of CRKP11, CRKP19, and CRKP26 and the control strain K. pneumoniae ATCC13883. ( C ) Time-kill kinetics assay for CRKP11, CRKP19, and CRKP26, and the control strain K. pneumoniae ATCC13883. ( D ) MIC values for the heteroresistant strains CRKP11, CRKP19, and CRKP26, and their resistant subpopulations (RS). Red lines indicate average values of three WT strain replicates. Green lines indicate average values of resistant subpopulation replicates. ( E ) MIC values of CZA for the passaged resistant subpopulations were determined at passages 0, 10, and 30 days. Shading indicates SEM values.
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liofilchem aztreonam avibactam gradient strip  (Liofilchem)
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Distribution of MIC values from ETEST AZA and BMD on clinical and challenge isolates. ( A ) FDA breakpoints ( N = 602) and ( B ) EUCAST breakpoints ( N = 650), with their respective interpretation noted on the top and left of the plot. Gray rectangles represent MICs in essential agreement, defined as MICs within ±1 doubling dilution. Abbreviations: MIC, minimal inhibitory concentration; AZA, <t>aztreonam-avibactam;</t> BMD, broth microdilution; S, susceptible; I, intermediate; R, resistant.
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Distribution of MIC values from ETEST AZA and BMD on clinical and challenge isolates. ( A ) FDA breakpoints ( N = 602) and ( B ) EUCAST breakpoints ( N = 650), with their respective interpretation noted on the top and left of the plot. Gray rectangles represent MICs in essential agreement, defined as MICs within ±1 doubling dilution. Abbreviations: MIC, minimal inhibitory concentration; AZA, <t>aztreonam-avibactam;</t> BMD, broth microdilution; S, susceptible; I, intermediate; R, resistant.
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Distribution of MIC values from ETEST AZA and BMD on clinical and challenge isolates. ( A ) FDA breakpoints ( N = 602) and ( B ) EUCAST breakpoints ( N = 650), with their respective interpretation noted on the top and left of the plot. Gray rectangles represent MICs in essential agreement, defined as MICs within ±1 doubling dilution. Abbreviations: MIC, minimal inhibitory concentration; AZA, <t>aztreonam-avibactam;</t> BMD, broth microdilution; S, susceptible; I, intermediate; R, resistant.
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Distribution of MIC values from ETEST AZA and BMD on clinical and challenge isolates. ( A ) FDA breakpoints ( N = 602) and ( B ) EUCAST breakpoints ( N = 650), with their respective interpretation noted on the top and left of the plot. Gray rectangles represent MICs in essential agreement, defined as MICs within ±1 doubling dilution. Abbreviations: MIC, minimal inhibitory concentration; AZA, <t>aztreonam-avibactam;</t> BMD, broth microdilution; S, susceptible; I, intermediate; R, resistant.
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CZA-heteroresistant strains and stability of their resistant subpopulations among the 25 clinical carbapenem-resistant Klebsiella pneumoniae isolates. ( A ) Satellite colonies in the CZA E-test strip for the CRKP11, CRKP19, and CRKP26 strains. ( B ) Population analysis profiles of CRKP11, CRKP19, and CRKP26 and the control strain K. pneumoniae ATCC13883. ( C ) Time-kill kinetics assay for CRKP11, CRKP19, and CRKP26, and the control strain K. pneumoniae ATCC13883. ( D ) MIC values for the heteroresistant strains CRKP11, CRKP19, and CRKP26, and their resistant subpopulations (RS). Red lines indicate average values of three WT strain replicates. Green lines indicate average values of resistant subpopulation replicates. ( E ) MIC values of CZA for the passaged resistant subpopulations were determined at passages 0, 10, and 30 days. Shading indicates SEM values.

Journal: Microbiology Spectrum

Article Title: Tandem amplification of the umpA allele contributes to ceftazidime-avibactam heteroresistance in clinical carbapenem-resistant Klebsiella pneumoniae isolates

doi: 10.1128/spectrum.01722-25

Figure Lengend Snippet: CZA-heteroresistant strains and stability of their resistant subpopulations among the 25 clinical carbapenem-resistant Klebsiella pneumoniae isolates. ( A ) Satellite colonies in the CZA E-test strip for the CRKP11, CRKP19, and CRKP26 strains. ( B ) Population analysis profiles of CRKP11, CRKP19, and CRKP26 and the control strain K. pneumoniae ATCC13883. ( C ) Time-kill kinetics assay for CRKP11, CRKP19, and CRKP26, and the control strain K. pneumoniae ATCC13883. ( D ) MIC values for the heteroresistant strains CRKP11, CRKP19, and CRKP26, and their resistant subpopulations (RS). Red lines indicate average values of three WT strain replicates. Green lines indicate average values of resistant subpopulation replicates. ( E ) MIC values of CZA for the passaged resistant subpopulations were determined at passages 0, 10, and 30 days. Shading indicates SEM values.

Article Snippet: CZA heteroresistance in the K. pneumoniae clinical isolates was confirmed by PAP for colonies growing within the inhibitory zone in the CZA gradient strip testing (Liofilchem, Roseto degli Abruzzi, Italy).

Techniques: Stripping Membranes, Control

Distribution of MIC values from ETEST AZA and BMD on clinical and challenge isolates. ( A ) FDA breakpoints ( N = 602) and ( B ) EUCAST breakpoints ( N = 650), with their respective interpretation noted on the top and left of the plot. Gray rectangles represent MICs in essential agreement, defined as MICs within ±1 doubling dilution. Abbreviations: MIC, minimal inhibitory concentration; AZA, aztreonam-avibactam; BMD, broth microdilution; S, susceptible; I, intermediate; R, resistant.

Journal: Journal of Clinical Microbiology

Article Title: A multicenter performance evaluation of aztreonam-avibactam gradient diffusion susceptibility testing for Enterobacterales

doi: 10.1128/jcm.01749-25

Figure Lengend Snippet: Distribution of MIC values from ETEST AZA and BMD on clinical and challenge isolates. ( A ) FDA breakpoints ( N = 602) and ( B ) EUCAST breakpoints ( N = 650), with their respective interpretation noted on the top and left of the plot. Gray rectangles represent MICs in essential agreement, defined as MICs within ±1 doubling dilution. Abbreviations: MIC, minimal inhibitory concentration; AZA, aztreonam-avibactam; BMD, broth microdilution; S, susceptible; I, intermediate; R, resistant.

Article Snippet: One other gradient diffusion method has been evaluated, the Liofilchem aztreonam-avibactam gradient strip ( ).

Techniques: Concentration Assay