JAC Advance Access originally published online on May 18, 2004
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Journal of Antimicrobial Chemotherapy 2004 54(1):134-138; doi:10.1093/jac/dkh274
JAC vol.54 no.1 © The British Society for Antimicrobial Chemotherapy 2004; all rights reserved.
Evaluation of a new cefepime–clavulanate ESBL Etest to detect extended-spectrum ß-lactamases in an Enterobacteriaceae strain collection
Institut für Infektionsmedizin, Zentrum für Klinisch-Theoretische Medizin I, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany
* Corresponding author. Tel: +49-40-42803-3147; Fax: +49-40-42803-4881; Email: e.stuerenburg{at}uke.uni-hamburg.de
Objectives: In this study, we evaluated the performance of a new ESBL Etest configuration based on clavulanate synergy with cefepime compared with cefotaxime–clavulanate and ceftazidime–clavulanate ESBL Etest strips for the detection of extended-spectrum ß-lactamases (ESBL) in an Enterobacteriaceae strain collection, with special focus on Enterobacter spp.
Methods: Overall, a total of 54 clinical isolates of ESBL-producing Enterobacteriaceae species were evaluated: Enterobacter aerogenes (n=3), Enterobacter cloacae (n=10), Escherichia coli (n=10), Klebsiella oxytoca (n=3), Klebsiella pneumoniae (n=25) and Proteus mirabilis (n=3). To check Etest behaviour with resistance phenotypes similar to ESBL, our panel was expanded by six clinical isolates of K. oxytoca that were identified as putative producers of their chromosomal K1 ß-lactamase.
Results: With this panel, ESBL Etest was 98% sensitive with cefepime–clavulanate, 83% with cefotaxime–clavulanate, and 74% with ceftazidime–clavulanate strips. Concentrating on Enterobacter spp., reliable ESBL detection could only be achieved by the new cefepime–clavulanate strip since it confirmed ESBL production in all strains (100% sensitivity) whereas only 4/13 (31%) of Enterobacter strains were positive using cefotaxime–clavulanate or ceftazidime–clavulanate strips. A limitation of using the new cefepime strip was less than optimal specificity with K1 phenotypes of K. oxytoca: among six strains, four isolates were scored false-positive by Etest strips containing cefepime–clavulanate.
Conclusion: The new Etest ESBL strip containing cefepime–clavulanate is a valuable supplement to current methods for detection of ESBLs. In our study collection, the cefepime–clavulanate strip was the best configuration for detection of ESBLs, particularly in Enterobacter spp.
Keywords: ESBL detection , Etest methodology
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  P. Apfalter, O. Assadian, F. Daxbock, A. M. Hirschl, M. L. Rotter, and A. Makristathis Extended double disc synergy testing reveals a low prevalence of extended-spectrum {beta}-lactamases in Enterobacter spp. in Vienna, Austria J. Antimicrob. Chemother., May 1, 2007; 59(5): 854 - 859. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Wiegand, H. K. Geiss, D. Mack, E. Sturenburg, and H. Seifert Detection of Extended-Spectrum Beta-Lactamases among Enterobacteriaceae by Use of Semiautomated Microbiology Systems and Manual Detection Procedures J. Clin. Microbiol., April 1, 2007; 45(4): 1167 - 1174. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Spanu, M. Sanguinetti, M. Tumbarello, T. D'Inzeo, B. Fiori, B. Posteraro, R. Santangelo, R. Cauda, and G. Fadda Evaluation of the New VITEK 2 Extended-Spectrum Beta-Lactamase (ESBL) Test for Rapid Detection of ESBL Production in Enterobacteriaceae Isolates. J. Clin. Microbiol., September 1, 2006; 44(9): 3257 - 3262. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Rossi, F. Baquero, P.-R. Hsueh, D. L. Paterson, G. V. Bochicchio, T. A. Snyder, V. Satishchandran, K. McCarroll, M. J. DiNubile, and J. W. Chow In vitro susceptibilities of aerobic and facultatively anaerobic Gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: 2004 results from SMART (Study for Monitoring Antimicrobial Resistance Trends) J. Antimicrob. Chemother., July 1, 2006; 58(1): 205 - 210. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Schwaber, S. Navon-Venezia, I. Chmelnitsky, A. Leavitt, D. Schwartz, and Y. Carmeli Utility of the VITEK 2 Advanced Expert System for Identification of Extended-Spectrum {beta}-Lactamase Production in Enterobacter spp. J. Clin. Microbiol., January 1, 2006; 44(1): 241 - 243. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. S. Burgess and C. R. Frei Comparison of {beta}-lactam regimens for the treatment of Gram-negative pulmonary infections in the intensive care unit based on pharmacokinetics/pharmacodynamics J. Antimicrob. Chemother., November 1, 2005; 56(5): 893 - 898. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. G. Winstanley, H. K. Parsons, M. A. Horstkotte, I. Sobottka, and E. Sturenburg Phenotypic detection of {beta}-lactamase-mediated resistance to oxyimino-cephalosporins in Enterobacteriaceae: evaluation of the Mastascan Elite Expert System J. Antimicrob. Chemother., August 1, 2005; 56(2): 292 - 296. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. L. Paterson, F. Rossi, F. Baquero, P.-R. Hsueh, G. L. Woods, V. Satishchandran, T. A. Snyder, C. M. Harvey, H. Teppler, M. J. DiNubile, et al. In vitro susceptibilities of aerobic and facultative Gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: the 2003 Study for Monitoring Antimicrobial Resistance Trends (SMART) J. Antimicrob. Chemother., June 1, 2005; 55(6): 965 - 973. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Sturenburg, M. Lang, M. A. Horstkotte, R. Laufs, and D. Mack Evaluation of the MicroScan ESBL plus confirmation panel for detection of extended-spectrum {beta}-lactamases in clinical isolates of oxyimino-cephalosporin-resistant Gram-negative bacteria J. Antimicrob. Chemother., November 1, 2004; 54(5): 870 - 875. [Abstract] [Full Text] [PDF]
|
|