Combination disk diffusion test (CDDT) was performed for presumptive identification of MBLs by imipenem, meropenem, doripenem, and ertapenem (Mast Group, Merseyside, UK) alone and in combination with EDTA [9 (link)]. Detection of ESBLs was tested for all the isolates by combination disk diffusion test (CDDT) containing ceftazidime (CAZ) and cefotaxime (CTX) with CAZ 30 μg + CA 10 μg and CTX 30 μg + CA 10 μg per disc (Mast Group, Merseyside, UK). The zones of inhibition were compared for the CTX, CAZ discs with that of the CAZ 30 μg + clavulanic acid (CA) 10 μg and CTX 30 μg + CA 10 μg disc. An increase in zone diameter of ≥5 mm in the presence of clavulanic acid was interpreted positive for the presence of ESBL in the test organism. Escherichia coli ATCC25922 and K. pneumoniae ATCC700603 were used as negative and positive controls for ESBL production, respectively. Presumptive identification of KPC enzyme was performed for all the K. pneumoniae isolates by modified Hodge test [7 (link)]. Amp-C was detected using the D69C AmpC Detection kit developed by Mast Group [10 (link)].
Doripenem
Manufactured by Mast Group
Sourced in United Kingdom
Doripenem is a broad-spectrum carbapenem antibiotic used in the treatment of various bacterial infections. It functions by inhibiting bacterial cell wall synthesis, leading to cell lysis and death.
Automatically generated - may contain errors
Lab products found in correlation
Meropenem, by Mast Group (3 mentions)
Imipenem, by Mast Group (3 mentions)
Piperacillin, by Mast Group (2 mentions)
Piperacillin tazobactam, by Mast Group (2 mentions)
Ceftazidime, by Mast Group (2 mentions)
Cefepime, by Mast Group (2 mentions)
Ciprofloxacin, by Mast Group (2 mentions)
Ertapenem, by Mast Group (1 mentions)
Trimethoprim sulfamethoxazole, by Mast Group (1 mentions)
Muller hinton agar, by Merck Group (1 mentions)
Cefotaxime, by Mast Group (1 mentions)
Levofloxacin, by Mast Group (1 mentions)
Aztreonam, by Mast Group (1 mentions)
Meropenem, by Liofilchem (1 mentions)
Tobramycin, by Mast Group (1 mentions)
E test, by Liofilchem (1 mentions)
Doripenem, by Liofilchem (1 mentions)
Colistin, by Mast Group (1 mentions)
Amikacin, by Mast Group (1 mentions)
Gentamicin, by Mast Group (1 mentions)
3 protocols using doripenem
1
Comprehensive Antibiotic Resistance Profiling
2
Antibiotic Susceptibility Profiling of Bacterial Isolates
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The antibiotic susceptibility pattern of the isolates was determined by the disk agar diffusion method on Muller Hinton agar (Merck, Germany) according to the Clinical and Laboratory Standards Institute (CLSI) guidelines21 . The antibiotics included piperacillin (100 µg), piperacillin-tazobactam (100/10 µg), imipenem (10 µg), meropenem (10 µg), doripenem (10 µg), ciprofloxacin (5 µg), levofloxacin (5 µg), trimethoprim-sulfamethoxazole (1.25-23.75 µg), ceftazidime (30 µg), cefotaxime (30 µg), and cefepime (30 µg) (MAST Co., England). The susceptibility pattern of the isolates against aminoglycosides including kanamycin, amikacin, spectinomycin, netilmicin, gentamicin, streptomycin, and tobramycin was determined using the micro-broth dilution method according to the CLSI guidelines21 . For interpretation of the minimum inhibitory concentration (MIC) values, we referred to the CLSI guidelines and previous studies1 ,21 ,22 . Escherichia coli ATCC 25922 and A. baumannii ATCC 19606 were used as control strains for antibiotic susceptibility testing.
3
Antimicrobial Susceptibility Testing for Bacterial Isolates
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Antimicrobial susceptibility testing for the bacterial isolates was carried out using the Kirby-Bauer method, as recommended by the Clinical and Laboratory Standards Institute (CLSI). 15 The following antibiotics were tested: imipenem (10 μg), meropenem (10 μg), doripenem (10 μg), ceftazidime (30 μg), cefepime (30 μg), piperacillin (100 μg), piperacillin/tazobactam (100/10 μg), gentamicin (10 μg), amikacin (30 μg), tobramycin (10 μg), ciprofloxacin (5 μg), aztreonam (30 μg), polymyxin B (300 units), and colistin (10 μg) (Mast Group Ltd, UK). The minimum inhibitory concentrations (MICs) of carbapenems (imipenem [IMI], meropenem [MRP], and doripenem [DOR]) were obtained by an E-test (Liofilchem, Italy), as described in the manufacturer's instructions. Carbapenem resistance was determined based on the MIC breakpoints. When an isolate was resistant to three carbapenems (imipenem, meropenem, and doripenem), that isolate was considered high-level carbapenem resistant. If an isolate was resistant to three or more classes of antimicrobial agents (i.e., penicillins/cephalosporins, carbapenems, aminoglycosides, and fluoroquinolones), that isolate was considered multidrug resistant (MDR). In accordance with the CLSI guidelines, P. aeruginosa ATCC 27853 and Escherichia coli ATCC 25922 were used as control strains in all susceptibility assays.
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