Occurrence and detection of extended-spectrum beta-lactamases in members of the family Enterobacteriaceae at a veterans medical center: seek and you may find

J Clin Microbiol. 1997 Oct;35(10):2593-7. doi: 10.1128/jcm.35.10.2593-2597.1997.

Abstract

A total of 907 consecutive isolates of members of the family Enterobacteriaceae recovered during a 20-week period were tested for production of extended-spectrum beta-lactamases (ESBLs) by the double-disk (DD) potentiation method. Of 84 DD-positive isolates, 83 (9.2%) produced ESBLs based on isoelectric focusing. SHV-derived ESBLs and several TEM-derived ESBLs were present in nine species, including the first isolate of Citrobacter koserii and Morganella morganii known to harbor an SHV-derived ESBL. Results of testing 58 nonrepeat isolates for ESBL production by several recommended methods were as follows (percent detected in parentheses): DD method with aztreonam (95), ceftazidime (79), ceftriaxone (88), or cefpodoxime (90); broth microdilution method with ceftazidime (86) or cefotaxime (91) alone or in combination with clavulanate; and the standard disk diffusion method with new breakpoints and standard concentrations of aztreonam (78), ceftazidime (79), ceftriaxone (83), or cefpodoxime (98) or a novel concentration (5 microg) of ceftazidime (88). In three instances during an extended part of the study, an ESBL-producing isolate and a non-ESBL-producing isolate of the same species were recovered from a single blood culture bottle. These data indicate that ESBLs occur in several species of Enterobacteriaceae and at a relatively high incidence at our institution and that the standard disk diffusion method with cefpodoxime and the DD method with several beta-lactams are practical and cost-effective methods for detecting ESBL-producing isolates of Enterobacteriaceae.

Publication types

  • Comparative Study

MeSH terms

  • Aztreonam / metabolism
  • Aztreonam / pharmacology
  • Cefpodoxime
  • Ceftazidime / metabolism
  • Ceftazidime / pharmacology
  • Ceftizoxime / analogs & derivatives
  • Ceftizoxime / metabolism
  • Ceftizoxime / pharmacology
  • Ceftriaxone / metabolism
  • Ceftriaxone / pharmacology
  • Enterobacteriaceae / classification
  • Enterobacteriaceae / enzymology*
  • Enterobacteriaceae / isolation & purification
  • Hospitals, Veterans
  • Isoelectric Focusing
  • Microbial Sensitivity Tests
  • Species Specificity
  • Substrate Specificity
  • beta-Lactam Resistance / physiology
  • beta-Lactamases / metabolism*
  • beta-Lactams / metabolism*

Substances

  • beta-Lactams
  • Ceftriaxone
  • Ceftazidime
  • Ceftizoxime
  • beta-Lactamases
  • Aztreonam