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Journal of Clinical Microbiology, November 2007, p. 3762-3763, Vol. 45, No. 11
0095-1137/07/$08.00+0     doi:10.1128/JCM.00968-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Narrow-Spectrum Cephalosporin Susceptibility Testing of Escherichia coli with the BD Phoenix Automated System: Questionable Utility of Cephalothin as a Predictor of Cephalexin Susceptibility{triangledown}

Sean X. Zhang,1,3 Fern Parisian,1 Yvonne Yau,1,3 Jeffrey D. Fuller,3 Susan M. Poutanen,2,3 and Susan E. Richardson1,3*

Division of Microbiology, Hospital for Sick Children,1 Toronto Medical Laboratories and Mount Sinai Hospital,2 Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada3

Received 9 May 2007/ Returned for modification 3 July 2007/ Accepted 20 August 2007

The resistance of Escherichia coli to cephalothin was found to be overestimated when the Phoenix automated susceptibility system was used to determine resistance compared to reference broth microdilution, a finding that jeopardized the use of cephalexin for first-line treatment of urinary tract infections in children. In addition, using broth microdilution, we studied the accuracy of either cephalothin or cefazolin in predicting cephalexin susceptibility. In contrast to the recommendation of the Clinical Laboratory Standards Institute (CLSI), we found that cephalothin is not a reliable predictor of cephalexin susceptibility. Cefazolin performs no better in this role. We suggest that laboratories should consider testing and reporting cefazolin and cephalexin independently, according to clinical need.

* Corresponding author. Mailing address: Division of Microbiology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada. Phone: (416) 813-5992. Fax: (416) 813-6257. E-mail: susan.richardson{at}sickkids.ca

{triangledown} Published ahead of print on 29 August 2007.

Journal of Clinical Microbiology, November 2007, p. 3762-3763, Vol. 45, No. 11
0095-1137/07/$08.00+0     doi:10.1128/JCM.00968-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.





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