PMID:8815106
| Citation |
Jacoby, GA and Han, P (1996) Detection of extended-spectrum beta-lactamases in clinical isolates of Klebsiella pneumoniae and Escherichia coli. J. Clin. Microbiol. 34:908-11 |
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| Abstract |
Forty clinical isolates of Escherichia coli and 141 isolates of Klebsiella pneumoniae that either transferred ceftazidime resistance or showed sulbactam enhancement of oxyimino-beta-lactam susceptibility were tested by disk diffusion methodology for susceptibility to aztreonam, cefotaxime, ceftazidime, and cefoxitin. With standard 30 micrograms antibiotic disks, the fraction of these extended-spectrum beta-lactamase (ESBL)-producing isolates testing resistant by National Committee for Clinical Laboratory Standards criteria was lowest (24%) with cefotaxime disks. Forty percent of the E. coli and 29% of the K. pneumoniae isolates appeared susceptible with at least one oxyimino-beta-lactam disk. Ceftazidime and aztreonam disks were equivalent in differentiating ESBL production, and both were superior to cefotaxime disks. Over half the E. Coli and 29% of the K. pneumoniae isolates tested cefoxitin resistant. In 30 isolates, cefoxitin resistance was transmissible and due to a plasmid-mediated AmpC-type beta-lactamase. With a 5-micrograms ceftazidime disk, a breakpoint could be chosen with high sensitivity and specificity for ESBL-producing organisms. Present disk diffusion criteria underestimate the prevalence of ESBL-producing strains. |
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| Keywords |
Anti-Bacterial Agents/pharmacology; Aztreonam/pharmacology; Cefotaxime/pharmacology; Cefoxitin/pharmacology; Ceftazidime/pharmacology; Drug Resistance, Microbial/genetics; Escherichia coli/drug effects; Escherichia coli/enzymology; Escherichia coli/isolation & purification; Humans; Klebsiella pneumoniae/drug effects; Klebsiella pneumoniae/enzymology; Klebsiella pneumoniae/isolation & purification; Microbial Sensitivity Tests; Plasmids/genetics; beta-Lactamases/analysis; beta-Lactamases/biosynthesis; beta-Lactamases/genetics |
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