This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Tenover, F. C.
Right arrow Articles by Dembek, Z. F.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Tenover, F. C.
Right arrow Articles by Dembek, Z. F.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, December 1999, p. 4065-4070, Vol. 37, No. 12
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Detection and Reporting of Organisms Producing Extended-Spectrum beta -Lactamases: Survey of Laboratories in Connecticut

Fred C. Tenover,1,* M. Jasmine Mohammed,1 Timothy S. Gorton,2 and Zygmunt F. Dembek3

Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia 303331; University of Connecticut, Department of Pathobiology, Storrs, Connecticut 062692; and Epidemiology Program, Connecticut Department of Public Health, Hartford, Connecticut 06134-03083

Received 30 June 1999/Returned for modification 5 August 1999/Accepted 1 September 1999

Extended-spectrum beta -lactamases (ESBLs) are enzymes produced in some gram-negative bacilli that mediate resistance to extended-spectrum cephalosporins and aztreonam. They are most common in Klebsiella spp. and Escherichia coli but are present in a variety of Enterobacteriaceae. Resistance mediated by these enzymes can be difficult to detect depending on the antimicrobial agents tested. AmpC beta -lactamases are related to the chromosomal enzymes of Enterobacter and Citrobacter spp. and also mediate resistance to extended-spectrum cephalosporins and aztreonam in addition to cephamycins, such as cefoxitin. Unlike ESBLs, however, AmpC beta -lactamases are not inhibited by clavulanic acid or other similar compounds. To assess the abilities of various antimicrobial susceptibility testing methods to detect ESBLs, we sent three ESBL-producing organisms, one AmpC-producing organism, and a control strain that was susceptible to extended-spectrum cephalosporins to 38 laboratories in Connecticut for testing. Eight (21.0%) of 38 labs failed to detect extended-spectrum cephalosporin or aztreonam resistance in any of the ESBL- or AmpC-producing isolates. Errors were encountered with both automated and disk diffusion methods. Conversely, seven (18.4%) labs categorized at least some of the four resistant isolates as potential ESBL producers and reported the results with the extended-spectrum cephalosporins and aztreonam as resistant as suggested by current National Committee for Clinical Laboratory Standards (NCCLS) guidelines. The percentage of laboratories that failed to detect resistance in the ESBL or AmpC isolates ranged from 23.7 to 31.6% depending on the type of enzyme present in the test organism. This survey suggests that many laboratories have difficulty detecting resistance in ESBL and AmpC-producing organisms and may be unaware of the NCCLS guidelines on modifying susceptibility testing reports for ESBL-producing strains.

* Corresponding author. Mailing address: Nosocomial Pathogens Laboratory Branch (G08), Hospital Infections Program, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333. Phone: (404) 639-3246. Fax: (404) 639-1381. E-mail: fnt1{at}CDC.GOV.

Journal of Clinical Microbiology, December 1999, p. 4065-4070, Vol. 37, No. 12
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


This article has been cited by other articles:

  • Paterson, D. L., Bonomo, R. A. (2005). Extended-Spectrum {beta}-Lactamases: a Clinical Update. Clin. Microbiol. Rev. 18: 657-686 [Abstract] [Full Text]  
  • Pitout, J. D. D., Nordmann, P., Laupland, K. B., Poirel, L. (2005). Emergence of Enterobacteriaceae producing extended-spectrum {beta}-lactamases (ESBLs) in the community. J Antimicrob Chemother 56: 52-59 [Abstract] [Full Text]  
  • Zaoutis, T. E., Goyal, M., Chu, J. H., Coffin, S. E., Bell, L. M., Nachamkin, I., McGowan, K. L., Bilker, W. B., Lautenbach, E. (2005). Risk Factors for and Outcomes of Bloodstream Infection Caused by Extended-Spectrum {beta}-Lactamase-Producing Escherichia coli and Klebsiella Species in Children. Pediatrics 115: 942-949 [Abstract] [Full Text]  
  • Jacoby, G. A., Munoz-Price, L. S. (2005). The New {beta}-Lactamases. NEJM 352: 380-391 [Full Text]  
  • Pitout, J. D. D., Hossain, A., Hanson, N. D. (2004). Phenotypic and Molecular Detection of CTX-M-{beta}-Lactamases Produced by Escherichia coli and Klebsiella spp.. J. Clin. Microbiol. 42: 5715-5721 [Abstract] [Full Text]  
  • Morris, D., O'Hare, C., Glennon, M., Maher, M., Corbett-Feeney, G., Cormican, M. (2003). Extended-Spectrum {beta}-Lactamases in Ireland, Including a Novel Enzyme, TEM-102. Antimicrob. Agents Chemother. 47: 2572-2578 [Abstract] [Full Text]  
  • Tenover, F. C., Raney, P. M., Williams, P. P., Rasheed, J. K., Biddle, J. W., Oliver, A., Fridkin, S. K., Jevitt, L., McGowan, J. E. Jr. (2003). Evaluation of the NCCLS Extended-Spectrum {beta}-Lactamase Confirmation Methods for Escherichia coli with Isolates Collected during Project ICARE. J. Clin. Microbiol. 41: 3142-3146 [Abstract] [Full Text]  
  • Canton, R., Loza, E., Del Carmen Conejo, M., Baquero, F., Martinez-Martinez, L. (2003). Quality Control for {beta}-Lactam Susceptibility Testing with a Well-Defined Collection of Enterobacteriaceae and Pseudomonas aeruginosa Strains in Spain. J. Clin. Microbiol. 41: 1912-1918 [Abstract] [Full Text]  
  • Byington, C. L., Rittichier, K. K., Bassett, K. E., Castillo, H., Glasgow, T. S., Daly, J., Pavia, A. T. (2003). Serious Bacterial Infections in Febrile Infants Younger Than 90 Days of Age: The Importance of Ampicillin-Resistant Pathogens. Pediatrics 111: 964-968 [Abstract] [Full Text]  
  • Moland, E. S., Black, J. A., Ourada, J., Reisbig, M. D., Hanson, N. D., Thomson, K. S. (2002). Occurrence of Newer {beta}-Lactamases in Klebsiella pneumoniae Isolates from 24 U.S. Hospitals. Antimicrob. Agents Chemother. 46: 3837-3842 [Abstract] [Full Text]  
  • Kartali, G., Tzelepi, E., Pournaras, S., Kontopoulou, C., Kontos, F., Sofianou, D., Maniatis, A. N., Tsakris, A. (2002). Outbreak of Infections Caused by Enterobacter cloacae Producing the Integron-Associated {beta}-Lactamase IBC-1 in a Neonatal Intensive Care Unit of a Greek Hospital. Antimicrob. Agents Chemother. 46: 1577-1580 [Abstract] [Full Text]  
  • Perilli, M., Dell'Amico, E., Segatore, B., de Massis, M. R., Bianchi, C., Luzzaro, F., Rossolini, G. M., Toniolo, A., Nicoletti, G., Amicosante, G. (2002). Molecular Characterization of Extended-Spectrum {beta}-Lactamases Produced by Nosocomial Isolates of Enterobacteriaceae from an Italian Nationwide Survey. J. Clin. Microbiol. 40: 611-614 [Abstract] [Full Text]  
  • Feria, C., Ferreira, E., Correia, J. D., Goncalves, J., Canica, M. (2002). Patterns and mechanisms of resistance to {beta}-lactams and {beta}-lactamase inhibitors in uropathogenic Escherichia coli isolated from dogs in Portugal. J Antimicrob Chemother 49: 77-85 [Abstract] [Full Text]  
  • Spanu, T., Luzzaro, F., Perilli, M., Amicosante, G., Toniolo, A., Fadda, G. (2002). Occurrence of Extended-Spectrum {beta}-Lactamases in Members of the Family Enterobacteriaceae in Italy: Implications for Resistance to {beta}-Lactams and Other Antimicrobial Drugs. Antimicrob. Agents Chemother. 46: 196-202 [Abstract] [Full Text]  
  • Sanders, C. C., Ehrhardt, A. F., Moland, E. S., Thomson, K. S., Zimmer, B., Roe, D. E. (2002). {beta}lasEN: Microdilution Panel for Identifying {beta}-Lactamases Present in Isolates of Enterobacteriaceae. J. Clin. Microbiol. 40: 123-127 [Abstract] [Full Text]  
  • Bradford, P. A. (2001). Extended-Spectrum {beta}-Lactamases in the 21st Century: Characterization, Epidemiology, and Detection of This Important Resistance Threat. Clin. Microbiol. Rev. 14: 933-951 [Abstract] [Full Text]  
  • Naumiuk, L., Samet, A., Dziemaszkiewicz, E. (2001). Cefepime in vitro activity against derepressed extended-spectrum {beta}-lactamase (ESBL)-producing and non-ESBL-producing Enterobacter cloacae by a disc diffusion method. J Antimicrob Chemother 48: 321-322 [Full Text]  
  • Paterson, D. L., Ko, W.-C., Von Gottberg, A., Casellas, J. M., Mulazimoglu, L., Klugman, K. P., Bonomo, R. A., Rice, L. B., McCormack, J. G., Yu, V. L. (2001). Outcome of Cephalosporin Treatment for Serious Infections Due to Apparently Susceptible Organisms Producing Extended-Spectrum {beta}-Lactamases: Implications for the Clinical Microbiology Laboratory. J. Clin. Microbiol. 39: 2206-2212 [Abstract] [Full Text]  
  • Yano, H., Kuga, A., Okamoto, R., Kitasato, H., Kobayashi, T., Inoue, M. (2001). Plasmid-Encoded Metallo-{beta}-Lactamase (IMP-6) Conferring Resistance to Carbapenems, Especially Meropenem. Antimicrob. Agents Chemother. 45: 1343-1348 [Abstract] [Full Text]  
  • Girlich, D., Poirel, L., Leelaporn, A., Karim, A., Tribuddharat, C., Fennewald, M., Nordmann, P. (2001). Molecular Epidemiology of the Integron-Located VEB-1 Extended-Spectrum {beta}-Lactamase in Nosocomial Enterobacterial Isolates in Bangkok, Thailand. J. Clin. Microbiol. 39: 175-182 [Abstract] [Full Text]  
  • Tenover, F. C., Mohammed, M. J., Stelling, J., O'Brien, T., Williams, R. (2001). Ability of Laboratories To Detect Emerging Antimicrobial Resistance: Proficiency Testing and Quality Control Results from the World Health Organization's External Quality Assurance System for Antimicrobial Susceptibility Testing. J. Clin. Microbiol. 39: 241-250 [Abstract] [Full Text]  
  • Yan, J.-J., Ko, W.-C., Tsai, S.-H., Wu, H.-M., Jin, Y.-T., Wu, J.-J. (2000). Dissemination of CTX-M-3 and CMY-2 beta -Lactamases among Clinical Isolates of Escherichia coli in Southern Taiwan. J. Clin. Microbiol. 38: 4320-4325 [Abstract] [Full Text]  
  • Coudron, P. E., Moland, E. S., Thomson, K. S. (2000). Occurrence and Detection of AmpC Beta-Lactamases among Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis Isolates at a Veterans Medical Center. J. Clin. Microbiol. 38: 1791-1796 [Abstract] [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»