#AMRrounds called about this microbiology confirmed isolate and susceptibility results (AMR Step 1) associated with a clinically confirmed infection (Clinical ID Step 1) inquiring about AMR and treatment options.
AMR Step 2: Understanding natural (intrinsic) mechanisms of resistance.
Outer membrane protein A of A baumannii (AbOmpA) attributed to intrinsic resistance through interaction of OmpA-like domain and efflux pump. DOI: 10.1093/jac/dkx257
AMR Step 3: Understanding local, regional, and global AMR
Example from the ARLN surveillance data, 69% (n=27) CP-CRAB harbored NDM and 31% (n=12) harbored KPC but carbapenemase genes detected in <1% isolates (n=39/4,491).
AMR Step 4: Understanding mechanisms of acquired resistance.
Example from DOI: 10.1080/1120009X.2020.1847421 (also PBP modification).
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In 1954 [Yale J Biol Med], Bennett and Beeson reported “there is a lag period of about one hour between the time of the sudden influx of bacteria and onset of the rigor, and the blood is often sterile by the time fever begins.
Among seven medical centers and 1,436 patients, Riedel et al [J Clin Microbiol. 2008; 46(4): 1381-5] reported “the likelihood of documenting bloodstream infections was not significantly enhanced…at the time patients experienced temperature spikes”
In a retrospective report to determine predictors of bacteremia, Taniguchi et al [Springerplus.2013; 2: 624] reported: 1. Among 18-79 yrs of age, shaking chills had aOR 2.22 (95% CI: 1.09-4.51) 2. Among 80+ yrs of age, shaking chills had aOR 3.06 (95% CI: 1.3-7.19)