🌟 ABX Pearl of the Day: AmpC or ESBL?
📋 Q: How can I quickly spot the difference in AmpC and ESBL resistance patterns? 🤔
🩺 A: Step 1: Look at the organism. Step 2: Check ceftriaxone susceptibility. Here’s a quick & handy decision tree to inform ABX Rx 👇 #IDsky #MedSky #PharmSky
🔗 IDSA AMR Guidance
📋 Q: How can I quickly spot the difference in AmpC and ESBL resistance patterns? 🤔
🩺 A: Step 1: Look at the organism. Step 2: Check ceftriaxone susceptibility. Here’s a quick & handy decision tree to inform ABX Rx 👇 #IDsky #MedSky #PharmSky
🔗 IDSA AMR Guidance
November 25, 2024 at 7:37 PM
🆕✨Super interesting
How high-risk ESBL-Ecoli initially adapt to carbapenem exposures prior to acquiring carbapenem resistance?
ST131 mutants ▶️Erta exposure 🔼ESBL gene copies via IS26 mediated PCTns or mutations in outer membrane porin(Omp) genes
#idsky #microsky
academic.oup.com/jid/advance-...
How high-risk ESBL-Ecoli initially adapt to carbapenem exposures prior to acquiring carbapenem resistance?
ST131 mutants ▶️Erta exposure 🔼ESBL gene copies via IS26 mediated PCTns or mutations in outer membrane porin(Omp) genes
#idsky #microsky
academic.oup.com/jid/advance-...
Comprehensive Assessment of Initial Adaptation of ESBL Positive ST131 Escherichia coli to Carbapenem Exposure
High-risk ST131 E. coli strains, particularly C2/H30Rx subclades, adapt to initial carbapenem exposure by IS-mediated ESBL gene amplification. This gene am
academic.oup.com
November 28, 2024 at 6:46 AM
🆕✨Super interesting
How high-risk ESBL-Ecoli initially adapt to carbapenem exposures prior to acquiring carbapenem resistance?
ST131 mutants ▶️Erta exposure 🔼ESBL gene copies via IS26 mediated PCTns or mutations in outer membrane porin(Omp) genes
#idsky #microsky
academic.oup.com/jid/advance-...
How high-risk ESBL-Ecoli initially adapt to carbapenem exposures prior to acquiring carbapenem resistance?
ST131 mutants ▶️Erta exposure 🔼ESBL gene copies via IS26 mediated PCTns or mutations in outer membrane porin(Omp) genes
#idsky #microsky
academic.oup.com/jid/advance-...
'ESBL-producing Escherichia coli and Klebsiella pneumoniae from human carriage, the human-polluted environment, and food: molecular epidemiology of two prospective cohorts in five European metropolitan areas'
'human-to-human transmission most important driver'
www.medrxiv.org/content/10.1...
'human-to-human transmission most important driver'
www.medrxiv.org/content/10.1...
Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae from human carriage, the human-polluted environment, and food: molecular epidemiology of two prospective cohorts i...
Objectives For 475 ESBL-producing Escherichia coli (ESBL-Ec), and 171 ESBL-producing Klebsiella pneumoniae (ESBL-Kp) collected from human carriers, the human-polluted (hp)-environment, and food: (i) t...
www.medrxiv.org
November 29, 2024 at 9:35 AM
'ESBL-producing Escherichia coli and Klebsiella pneumoniae from human carriage, the human-polluted environment, and food: molecular epidemiology of two prospective cohorts in five European metropolitan areas'
'human-to-human transmission most important driver'
www.medrxiv.org/content/10.1...
'human-to-human transmission most important driver'
www.medrxiv.org/content/10.1...
▶️💥Tick tock, AMR clock: how should I treat my next ESBL bacteraemia patient?
Excellent talk by Prof Tong
Carbapenem sparing drug? Do we need it? Data? Does it increase CRE?
Bayesian priori
Next patient with ESBL : would you give pip tazo or Mero ?
#ESCMIDGlobal2026 @steventong.bsky.social 👏 #idsky
Excellent talk by Prof Tong
Carbapenem sparing drug? Do we need it? Data? Does it increase CRE?
Bayesian priori
Next patient with ESBL : would you give pip tazo or Mero ?
#ESCMIDGlobal2026 @steventong.bsky.social 👏 #idsky
April 20, 2026 at 4:43 PM
▶️💥Tick tock, AMR clock: how should I treat my next ESBL bacteraemia patient?
Excellent talk by Prof Tong
Carbapenem sparing drug? Do we need it? Data? Does it increase CRE?
Bayesian priori
Next patient with ESBL : would you give pip tazo or Mero ?
#ESCMIDGlobal2026 @steventong.bsky.social 👏 #idsky
Excellent talk by Prof Tong
Carbapenem sparing drug? Do we need it? Data? Does it increase CRE?
Bayesian priori
Next patient with ESBL : would you give pip tazo or Mero ?
#ESCMIDGlobal2026 @steventong.bsky.social 👏 #idsky
ID clinicians, how many of you feel obligated to choose a carbapenem for patients with a historical positive culture an ESBL producer? Help us validate our risk calculator at esblrisk.com ! #idsky #txsky #abxsky
ESBL Risk Calculator – Risk of an ESBL+ Culture
ESBL Calculator
esblrisk.com
February 17, 2025 at 7:22 PM
ID clinicians, how many of you feel obligated to choose a carbapenem for patients with a historical positive culture an ESBL producer? Help us validate our risk calculator at esblrisk.com ! #idsky #txsky #abxsky
"Sie haben den Krankenhauskeim auf Station! Das werde ich der Presse melden!"
"Oh, welchen meinen Sie denn?"
"Na DEN Keim!"
"Welcher denn nun? MRSA? 3 MRGN? 4MRGN? VRE? ESBL?"
...
"Clostridien? Covid? Hallo??? Wohin laufen Sie denn? Fleischfressende Vibrionen?????......."
"Oh, welchen meinen Sie denn?"
"Na DEN Keim!"
"Welcher denn nun? MRSA? 3 MRGN? 4MRGN? VRE? ESBL?"
...
"Clostridien? Covid? Hallo??? Wohin laufen Sie denn? Fleischfressende Vibrionen?????......."
October 19, 2023 at 2:56 PM
"Sie haben den Krankenhauskeim auf Station! Das werde ich der Presse melden!"
"Oh, welchen meinen Sie denn?"
"Na DEN Keim!"
"Welcher denn nun? MRSA? 3 MRGN? 4MRGN? VRE? ESBL?"
...
"Clostridien? Covid? Hallo??? Wohin laufen Sie denn? Fleischfressende Vibrionen?????......."
"Oh, welchen meinen Sie denn?"
"Na DEN Keim!"
"Welcher denn nun? MRSA? 3 MRGN? 4MRGN? VRE? ESBL?"
...
"Clostridien? Covid? Hallo??? Wohin laufen Sie denn? Fleischfressende Vibrionen?????......."
we're under-utilizing aminoglycosides for urosepsis in patients with good renal function
rising % ESBL is pushing us to use carbapenems for empiric therapy... leading to more resistance (CDiff, CRE)
aminoglycosides have minimal gut penetration = low CDiff risk & protect microbiome 🧵 #1/4 #EMIMCC
rising % ESBL is pushing us to use carbapenems for empiric therapy... leading to more resistance (CDiff, CRE)
aminoglycosides have minimal gut penetration = low CDiff risk & protect microbiome 🧵 #1/4 #EMIMCC
July 24, 2025 at 11:51 AM
we're under-utilizing aminoglycosides for urosepsis in patients with good renal function
rising % ESBL is pushing us to use carbapenems for empiric therapy... leading to more resistance (CDiff, CRE)
aminoglycosides have minimal gut penetration = low CDiff risk & protect microbiome 🧵 #1/4 #EMIMCC
rising % ESBL is pushing us to use carbapenems for empiric therapy... leading to more resistance (CDiff, CRE)
aminoglycosides have minimal gut penetration = low CDiff risk & protect microbiome 🧵 #1/4 #EMIMCC
Happy Friday! 🎉
A new episode just dropped: ESBL, UTIs & new antibiotics 💊🦠
What’s new? 🎙️ Link in comments.
#microbiology #podcast #ESBL #UTI #antibiotics
@ashlan-kunz-coyne.bsky.social
A new episode just dropped: ESBL, UTIs & new antibiotics 💊🦠
What’s new? 🎙️ Link in comments.
#microbiology #podcast #ESBL #UTI #antibiotics
@ashlan-kunz-coyne.bsky.social
August 15, 2025 at 9:39 PM
Happy Friday! 🎉
A new episode just dropped: ESBL, UTIs & new antibiotics 💊🦠
What’s new? 🎙️ Link in comments.
#microbiology #podcast #ESBL #UTI #antibiotics
@ashlan-kunz-coyne.bsky.social
A new episode just dropped: ESBL, UTIs & new antibiotics 💊🦠
What’s new? 🎙️ Link in comments.
#microbiology #podcast #ESBL #UTI #antibiotics
@ashlan-kunz-coyne.bsky.social
Annual Norwegian NORM/NORM-VET report released.
Norway’s strict antibiotic policies pay off. Record-low use in humans & animals, and some of Europe’s lowest #AMR rates. But ESBL & VRE are on the rise, so vigilance is vital.
www.unn.no/4a675d/sitea...
Norway’s strict antibiotic policies pay off. Record-low use in humans & animals, and some of Europe’s lowest #AMR rates. But ESBL & VRE are on the rise, so vigilance is vital.
www.unn.no/4a675d/sitea...
www.unn.no
September 16, 2025 at 5:34 PM
Annual Norwegian NORM/NORM-VET report released.
Norway’s strict antibiotic policies pay off. Record-low use in humans & animals, and some of Europe’s lowest #AMR rates. But ESBL & VRE are on the rise, so vigilance is vital.
www.unn.no/4a675d/sitea...
Norway’s strict antibiotic policies pay off. Record-low use in humans & animals, and some of Europe’s lowest #AMR rates. But ESBL & VRE are on the rise, so vigilance is vital.
www.unn.no/4a675d/sitea...
Carbapenem-First Therapy For ESBL-Producing Organisms?
Dr. Jason Pogue discusses the PETERPEN and MERINO trials. #IDsky #Medsky
Watch the full interview and see the accompanying article: www.contagionlive.com/view/further...
Dr. Jason Pogue discusses the PETERPEN and MERINO trials. #IDsky #Medsky
Watch the full interview and see the accompanying article: www.contagionlive.com/view/further...
October 5, 2026 at 2:56 PM
Carbapenem-First Therapy For ESBL-Producing Organisms?
Dr. Jason Pogue discusses the PETERPEN and MERINO trials. #IDsky #Medsky
Watch the full interview and see the accompanying article: www.contagionlive.com/view/further...
Dr. Jason Pogue discusses the PETERPEN and MERINO trials. #IDsky #Medsky
Watch the full interview and see the accompanying article: www.contagionlive.com/view/further...
🔥🔥Just published 🔥🔥
IDSA AMR Guidance 2026
IDSA 2026 Guidance on the Treatment of Antimicrobial Resistant Gram-Negative Infections
🔺ESBL , AmpC Enterobacterales
🔺CRE
🔺DTR P. aeruginosa
🔺CRAB
🔺Stenotrophomonas maltophilia #idsky
www.idsociety.org/practice-gui...
IDSA AMR Guidance 2026
IDSA 2026 Guidance on the Treatment of Antimicrobial Resistant Gram-Negative Infections
🔺ESBL , AmpC Enterobacterales
🔺CRE
🔺DTR P. aeruginosa
🔺CRAB
🔺Stenotrophomonas maltophilia #idsky
www.idsociety.org/practice-gui...
July 27, 2026 at 4:06 PM
🔥🔥Just published 🔥🔥
IDSA AMR Guidance 2026
IDSA 2026 Guidance on the Treatment of Antimicrobial Resistant Gram-Negative Infections
🔺ESBL , AmpC Enterobacterales
🔺CRE
🔺DTR P. aeruginosa
🔺CRAB
🔺Stenotrophomonas maltophilia #idsky
www.idsociety.org/practice-gui...
IDSA AMR Guidance 2026
IDSA 2026 Guidance on the Treatment of Antimicrobial Resistant Gram-Negative Infections
🔺ESBL , AmpC Enterobacterales
🔺CRE
🔺DTR P. aeruginosa
🔺CRAB
🔺Stenotrophomonas maltophilia #idsky
www.idsociety.org/practice-gui...
🔥Late Breakers
PeterPen RCT prelim results challenges carbapenem default in ESBL BSI
Pip/tazo vs MER (EI)
✅Non-inferior 7d failure(29.4% vs 33.5%)
❌No early mortality signal
30d mortality 14.4%(interim)
👉Will mortality follow?MERINO taught us the hard way!
#ESCMIDGlobal2026 #IDsky
PeterPen RCT prelim results challenges carbapenem default in ESBL BSI
Pip/tazo vs MER (EI)
✅Non-inferior 7d failure(29.4% vs 33.5%)
❌No early mortality signal
30d mortality 14.4%(interim)
👉Will mortality follow?MERINO taught us the hard way!
#ESCMIDGlobal2026 #IDsky
April 20, 2026 at 12:50 PM
🔥Late Breakers
PeterPen RCT prelim results challenges carbapenem default in ESBL BSI
Pip/tazo vs MER (EI)
✅Non-inferior 7d failure(29.4% vs 33.5%)
❌No early mortality signal
30d mortality 14.4%(interim)
👉Will mortality follow?MERINO taught us the hard way!
#ESCMIDGlobal2026 #IDsky
PeterPen RCT prelim results challenges carbapenem default in ESBL BSI
Pip/tazo vs MER (EI)
✅Non-inferior 7d failure(29.4% vs 33.5%)
❌No early mortality signal
30d mortality 14.4%(interim)
👉Will mortality follow?MERINO taught us the hard way!
#ESCMIDGlobal2026 #IDsky
💡 A: Many microbiology labs do not routinely perform ESBL -specific testing. Instead, since ESBLs hydrolyze third-generation beta-lactams, ceftriaxone non-susceptibility can be used as a proxy for ESBL production in certain GNRs that are at high risk for carrying ESBL:
August 6, 2025 at 4:45 PM
💡 A: Many microbiology labs do not routinely perform ESBL -specific testing. Instead, since ESBLs hydrolyze third-generation beta-lactams, ceftriaxone non-susceptibility can be used as a proxy for ESBL production in certain GNRs that are at high risk for carrying ESBL:
Today, let’s talk about the ESBL gift horses! They may get the job done, just don’t look in their mouth!
youtube.com/shorts/OKylg...
youtube.com/shorts/OKylg...
The ESBL Gift Horses - Zosyn and Cefepime
YouTube video by KetamineRx
youtube.com
October 5, 2026 at 8:45 PM
Today, let’s talk about the ESBL gift horses! They may get the job done, just don’t look in their mouth!
youtube.com/shorts/OKylg...
youtube.com/shorts/OKylg...
Ah yes, the famously medium-spectrum doxycycline.
It only covers
Staphylococci
Pneumococci
Beta haemolytic Streptococci
Actinomyces
Mycoplasma
Chlamydophila
Legionella
H.influenzae
Moraxella catarrhalis
ESBL E.coli UTI
Pseudomonas UTI(maybe!)
Burkholderia pseudomallei
Vibrio
H.pylori
1/2
It only covers
Staphylococci
Pneumococci
Beta haemolytic Streptococci
Actinomyces
Mycoplasma
Chlamydophila
Legionella
H.influenzae
Moraxella catarrhalis
ESBL E.coli UTI
Pseudomonas UTI(maybe!)
Burkholderia pseudomallei
Vibrio
H.pylori
1/2
August 23, 2025 at 11:02 PM
Ah yes, the famously medium-spectrum doxycycline.
It only covers
Staphylococci
Pneumococci
Beta haemolytic Streptococci
Actinomyces
Mycoplasma
Chlamydophila
Legionella
H.influenzae
Moraxella catarrhalis
ESBL E.coli UTI
Pseudomonas UTI(maybe!)
Burkholderia pseudomallei
Vibrio
H.pylori
1/2
It only covers
Staphylococci
Pneumococci
Beta haemolytic Streptococci
Actinomyces
Mycoplasma
Chlamydophila
Legionella
H.influenzae
Moraxella catarrhalis
ESBL E.coli UTI
Pseudomonas UTI(maybe!)
Burkholderia pseudomallei
Vibrio
H.pylori
1/2
ESBL plasmid compatibility with the surrounding microbial community influences ESBL gene survival under CRISPR-antimicrobial targeting https://www.biorxiv.org/content/10.1101/2025.04.15.648872v1
April 16, 2025 at 5:17 AM
ESBL plasmid compatibility with the surrounding microbial community influences ESBL gene survival under CRISPR-antimicrobial targeting https://www.biorxiv.org/content/10.1101/2025.04.15.648872v1
Clinic#1 2025:
Aspergillosis x 2
CMV
ESBL peri-nephric abscess
Histoplasmosis
Pre-SCT eval x 2
Empyema
Transplant/cancer ID Rocks!
Aspergillosis x 2
CMV
ESBL peri-nephric abscess
Histoplasmosis
Pre-SCT eval x 2
Empyema
Transplant/cancer ID Rocks!
January 3, 2025 at 5:45 PM
Clinic#1 2025:
Aspergillosis x 2
CMV
ESBL peri-nephric abscess
Histoplasmosis
Pre-SCT eval x 2
Empyema
Transplant/cancer ID Rocks!
Aspergillosis x 2
CMV
ESBL peri-nephric abscess
Histoplasmosis
Pre-SCT eval x 2
Empyema
Transplant/cancer ID Rocks!
Depends on your rate of community ESBL. If the rate is high, it is not irrational to give empiric carbapenem for a UTI in shock, and then de-escalate when non ESBL confirmed.
February 1, 2025 at 1:53 AM
Depends on your rate of community ESBL. If the rate is high, it is not irrational to give empiric carbapenem for a UTI in shock, and then de-escalate when non ESBL confirmed.
This study, apparently conducted in Chennai, found a high prevalence of MDR and ESBL-producing E. coli in UTI. 66% of isolates identified as MDR. WGS revealed key resistance genes (blaNDM-5 and CTX-M-15).
Genomic surveillance and targeted therapies are encouraged.
www.nature.com/articles/s41...
Genomic surveillance and targeted therapies are encouraged.
www.nature.com/articles/s41...
Prevalence and genomic insights of carbapenem resistant and ESBL producing Multidrug resistant Escherichia coli in urinary tract infections - Scientific Reports
Scientific Reports - Prevalence and genomic insights of carbapenem resistant and ESBL producing Multidrug resistant Escherichia coli in urinary tract infections
www.nature.com
January 20, 2025 at 5:04 PM
This study, apparently conducted in Chennai, found a high prevalence of MDR and ESBL-producing E. coli in UTI. 66% of isolates identified as MDR. WGS revealed key resistance genes (blaNDM-5 and CTX-M-15).
Genomic surveillance and targeted therapies are encouraged.
www.nature.com/articles/s41...
Genomic surveillance and targeted therapies are encouraged.
www.nature.com/articles/s41...
November 23, 2024 at 6:19 PM
#Covid (Massnahmen) reduzierten Krankenhaus Keime & Antibiotika!Einsatz in #Frankreich
MRSA ~37%⬇️
(ESBL)-producing Escherichia coli ~33%⬇️
ESBL-producing Klebsiella pneumoniae ~24%⬇️
during periods of strong anti-#C19 interventions in the community
#MaskeAuf
www.thelancet.com/journals/lan...
MRSA ~37%⬇️
(ESBL)-producing Escherichia coli ~33%⬇️
ESBL-producing Klebsiella pneumoniae ~24%⬇️
during periods of strong anti-#C19 interventions in the community
#MaskeAuf
www.thelancet.com/journals/lan...
Effects of the COVID-19 pandemic on antibiotic use and resistance in French hospitals, 2019–22: a retrospective ecological analysis of national surveillance data
Our results highlight alterations in antibiotic use and pathogen-specific effects of the pandemic on antibiotic resistance in hospitals. Although the biological mechanisms underlying between-species differences remain unclear, these results provide insights into the potential effects of a viral pandemic on antibiotic resistance and support the need for pandemic preparedness in health-care facilities.
www.thelancet.com
April 9, 2026 at 9:03 PM
#Covid (Massnahmen) reduzierten Krankenhaus Keime & Antibiotika!Einsatz in #Frankreich
MRSA ~37%⬇️
(ESBL)-producing Escherichia coli ~33%⬇️
ESBL-producing Klebsiella pneumoniae ~24%⬇️
during periods of strong anti-#C19 interventions in the community
#MaskeAuf
www.thelancet.com/journals/lan...
MRSA ~37%⬇️
(ESBL)-producing Escherichia coli ~33%⬇️
ESBL-producing Klebsiella pneumoniae ~24%⬇️
during periods of strong anti-#C19 interventions in the community
#MaskeAuf
www.thelancet.com/journals/lan...
Top threats include:
Carbapenem-resistant Enterobacterales (CRE)
Drug-resistant gonorrhea
MRSA (Staph aureus)
ESBL-producing E. coli and Klebsiella
C. difficile (worsened by antibiotic use)
Many hit hardest in hospitals, especially ICU settings.
Carbapenem-resistant Enterobacterales (CRE)
Drug-resistant gonorrhea
MRSA (Staph aureus)
ESBL-producing E. coli and Klebsiella
C. difficile (worsened by antibiotic use)
Many hit hardest in hospitals, especially ICU settings.
March 21, 2025 at 3:50 PM
Top threats include:
Carbapenem-resistant Enterobacterales (CRE)
Drug-resistant gonorrhea
MRSA (Staph aureus)
ESBL-producing E. coli and Klebsiella
C. difficile (worsened by antibiotic use)
Many hit hardest in hospitals, especially ICU settings.
Carbapenem-resistant Enterobacterales (CRE)
Drug-resistant gonorrhea
MRSA (Staph aureus)
ESBL-producing E. coli and Klebsiella
C. difficile (worsened by antibiotic use)
Many hit hardest in hospitals, especially ICU settings.