Low colonization rates with Multidrug-resistant Gram-negative bacteria in a German hospital-affiliated hemodialysis center
Fig 1
(A) Inoculation of stool samples on blood agar, endo agar, and chromogenic agar plates for ESBL and carbapenemase producers (ES and CA). (B) Application of antimicrobial susceptibility disks for piperacillin (P), cefotaxime (X), ceftazidime (T), ciprofloxacin (C) or ertapenem (E) to blood and endo agar plates. (C) After 24 hours of incubation at 36°C one colony of each phenotype (grey spots) within the inhibition zones was isolated. (D) In parallel, colonies growing on selective chromogenic media were isolated. (E) The isolated strains were identified by MALDI-TOF-MS and susceptibility testing was performed by microdilution using the VITEK®2 system. Semi-automated MIC determination was performed using CLSI breakpoints. Suspected ESBL production within the isolated strains was confirmed by MIC strip ESBL testing.