Bacterial isolates cultured as part of routine clinical diagnostics were acquired from a regional hospital in Central Texas. Isolates were obtained from patients both within the hospital and from other facilities (eg long-term care facilities) within the same region (from which isolates/samples were submitted to the hospital for testing) from December 2018 to January 2020. Species identification and antibiotic susceptibility testing were conducted on the VITEK 2 system using the GN ID card and the AST-GN69 and AST-XN06 susceptibility cards, respectively (BioMérieux). All isolates designated “ESBL” by VITEK analysis (n=116) or meeting the CDC definition of CRE (n=16) were included in this study. CRE is defined by the CDC as “Enterobacterales that test resistant to at least one of the carbapenem antibiotics”.8 CRE isolates (Klebsiella spp. and E. coli only) were submitted to the Texas Department of State Health Services (DSHS) for additional analyses per CDC recommendations.9 At DSHS they were tested for carbapenemase production (mCIM method).10 (link) MICs for select aminoglycosides, monobactams, carbapenems, cephalosporins, fluoroquinolones, tigecycline, polymyxins, piperacillin/tazobactam, and trimethoprim/sulfamethoxazole were also determined by broth microdilution (BMD). PCRs for important carbapenemase genes (blaKPC, blaOXA-48, blaNDM, blaIMP, and blaVIM) and colistin-resistance genes (mcr-1 and mcr-2) were also performed by DSHS. For a few of the CRE isolates, either the VITEK or the DSHS report was unavailable.