Detecting and Reporting Resistance Mechanisms in Gram-Negative Bacteria (by CACMLE) (Online Course)

Paul A. Schreckenberger, PhD, D(ABMM)

This self-study is divided in 2 parts and brings together a methodical and practical approach to detecting and reporting resistance mechanisms in gram positive and gram negative bacteria. It also discusses special requirements and result reporting for Antimicrobial Susceptibility Testing (AST). It serves as an excellent resource to educate students or working professionals who are interested in acquiring knowledge in this particular area of microbiology.

This course is divided into the following 2 sections:

I: A Look at Some of the new CLSI Recommendations for Antimicrobial Susceptibility Testing (AST) and Reporting.

II: Detecting Resistance in Gram-Negative Bacteria: A Continuing Challenge.

Presented in an easy-to-use PowerPoint slide format with corresponding audio, it’s just like being at a live presentation!

See all available courses »

Continuing Education Credits

  • Florida Board of Clinical Laboratory Science CE - General (Microbiology/Mycology/Parasitology): 3 hour(s)
  • P.A.C.E.® Contact Hours (CACMLE): 3 hour(s)


  • Recognize resistance mechanisms by observing patterns of susceptibility on the 10-disk test.
  • Modify antibiotic interpretations, based on the type(s) of resistance observed
  • Add appropriate interpretive comments to susceptibility reports to aid in physician understanding

Course Outline

  • PowerPoint Slides
      • Paul Schreckenberger, PhD, D(ABMM)
      • Detecting Resistance in Gram-Negative Bacteria
      • Learning Objectives
      • Do Mechanisms Count?
      • Do Mechanisms Count? cont.
      • The Gram Negative Cell Wall
      • Beta-Lactamase Classes
      • The Becta-lactam family of antibiotics
      • The Becta-lactam family of antibiotics - Action of ESBLs
      • The Becta-lactam family of antibiotics - Action of AmpCs
      • The Becta-lactam family of antibiotics - Action of Metallo beta-lactamases
      • The Becta-lactam family of antibiotics - Action of KPCs
      • Which of the following is/are true statement(s) for KPC beta-lactamases?
      • Combination Disk (CLSI) Method
      • Combination Disk (CLSI) Method - E. coli with ESBL
      • Double Disk Potentiation Method (10 Disk Test)
      • AmpC Beta Lactamases
      • E. cloacae expressing Inducible AmpC
      • Chromosomal AmpC that is not Expressing High Level Resistance
      • E. cloacae AmpC Derepressed Mutant
      • Chromosomal AmpC that is Expressing High Level Resistance
      • Double Disk Potentiation Method - E. coli with plasmid mediated AmpC, ESBL (-)
      • Reporting AmpCs in E. coli
      • Double Disk Potentiation Method - E. cloacae with chromosomal AmpC, ESBL (+)
      • ESBLs (Extended-Spectrum Beta-Lactamases) hydrolyze:
      • Double Disk Potentiation Method - K. oxytoca with chromosomal K1 BL, ESBL (-), AmpC (-)
      • Aztreonam and Cefoxitin are used in disk diffusion testing to detect K1 beta-lactamase.
      • Double Disk Potentiation Method - K. pneumoniae with KPC Beta Lactamase
      • KPCs hydrolyze:
      • Case 1
      • MicroScan Report
      • MicroScan Report, cont.
      • Case 1 - 10 Disk Test
      • Case 1 - Modified Hodge Test
      • And the answer is........
      • Molecular testing revealed SME-3. Where does SME fit among carbapenemases?
      • What is unique about SME as compared to KPC?
      • SME-3 Carbapenemases
      • SME-3 Carbapenemases, cont.
      • Case 1 - Pneumonia
      • Case 2
      • MicroScan Report
      • MicroScan Report, cont.
      • Case 2 - 10 Disk Method
      • Case 2 - Modified Hodge Test
      • Case 2 - Modified Hodge Test Result
      • Case 2 - MBL ETest for Metallo Beta-lactamase
      • And the answer is....
      • Initial Report of a New Metallo-Beta-Lactamase, NDM-1
      • Class B: Metallo-Beta-Lactamase
      • Metallo-Beta-Lactamase Families
      • NDM-1 in the United Kingdom
      • NDM-1 Goes Global
      • NDM-Producing Isolates in the U.S.
      • Susceptibility Profile of NDM-1 MBL-Producing Isolates
      • MMWR notice to readers
      • Message from Brandi Limbago
      • Enterobacteriaceae - Revised Carbapenem Breakpoints (MIC ug/ml)
      • Enterobacteriaceae - Revised Carbapenem Breakpoints (disk mm)
      • Recommendations
      • Conclusion

Just one user? Visit for individual subscriptions.
Slide 1

Slide 12

Slide 101

Slide 114

Slide 121

wp7991bcab 05 06