Meropenem resistance in imipenem-susceptible meropenem-resistant Klebsiella pneumoniae isolates not detected by rapid automated testing systems

J Clin Microbiol. 2013 Aug;51(8):2735-8. doi: 10.1128/JCM.02649-12. Epub 2013 May 29.


Klebsiella pneumoniae showing high resistance to all β-lactams except imipenem, designated as ISMRK (imipenem-susceptible meropenem-resistant Klebsiella) is emerging in Japan. The carbapenem resistance of ISMRK cannot be screened by the Vitek and the RAISUS rapid automated susceptibility test systems, which may lead to inappropriate antimicrobial therapy, resulting in compromised patient outcomes.

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Diagnostic Errors*
  • Humans
  • Imipenem / pharmacology*
  • Japan
  • Klebsiella Infections / microbiology*
  • Klebsiella pneumoniae / drug effects*
  • Klebsiella pneumoniae / isolation & purification
  • Meropenem
  • Microbial Sensitivity Tests / methods
  • Thienamycins / pharmacology*
  • beta-Lactam Resistance*


  • Anti-Bacterial Agents
  • Thienamycins
  • Imipenem
  • Meropenem