GNRs

if Gram negative rod from blood cultures- they set up API identification system, also innoculate mueller hinton plate.

if GNR, call and ask if enteric or non-enteric

they set up 4 different plates. 1) aerobic, blood plate, 2) anaerobic blood plate, 3) maconkey, 4) anaerobic PEA, selective for certain organisms.

if fat and plump, enteric most likely.  enteric = lactose fermenters on maconkey. and a few non-lactose fermenters like proteus

63% of Acinetobacter isolates, 13% of Pseudomonas isolates, adn 11% of klebsiella isolates causing HAI in the US are MDR. Emergence of resistanec to carbapenems (effective against ESBL) have limited treatment options.  CRE have spread at an alarming rate and have been identified in at least 44 US states.

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