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Journal of Clinical Microbiology, September 2006, p. 3318-3324, Vol. 44, No. 9
0095-1137/06/$08.00+0     doi:10.1128/JCM.00756-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Prevalence of Newer ß-Lactamases in Gram-Negative Clinical Isolates Collected in the United States from 2001 to 2002

Ellen S. Moland, Nancy D. Hanson, Jennifer A. Black, Ashfaque Hossain, Wonkeun Song, and Kenneth S. Thomson*

Center for Research in Anti-Infectives and Biotechnology (CRAB), Department of Medical Microbiology & Immunology, School of Medicine, Creighton University Medical Center, 2500 California Plaza, Omaha, Nebraska 68178

Received 10 April 2006/ Returned for modification 27 May 2006/ Accepted 15 July 2006

Newer ß-lactamases such as extended-spectrum ß-lactamases (ESBLs), transferable AmpC ß-lactamases, and carbapenemases are associated with laboratory testing problems of false susceptibility that can lead to inappropriate therapy for infected patients. Because there appears to be a lack of awareness of these enzymes, a study was conducted during 2001 to 2002 in which 6,421 consecutive, nonduplicate clinical isolates of aerobically growing gram-negative bacilli from patients at 42 intensive care unit (ICU) and 21 non-ICU sites across the United States were tested on-site for antibiotic susceptibility. From these isolates, 746 screen-positive isolates (11.6%) were referred to a research facility and investigated to determine the prevalence of ESBLs in all gram-negative isolates, transferable AmpC ß-lactamases in Klebsiella pneumoniae, and carbapenemases in Enterobacteriaceae. The investigations involved phenotypic tests, isoelectric focusing, ß-lactamase inhibitor studies, spectrophotometric assays, induction assays, and molecular analyses. ESBLs were detected only in Enterobacteriaceae (4.9% of all Enterobacteriaceae) and were found in species other than those currently recommended for ESBL testing by the CLSI (formerly NCCLS). These isolates occurred at 74% of the ICU sites and 43% of the non-ICU sites. Transferable AmpC ß-lactamases were detected in 3.3% of K. pneumoniae isolates and at 16 of the 63 sites (25%) with no difference between ICU and non-ICU sites. Three sites submitted isolates that produced class A carbapenemases. No class B or D carbapenemases were detected. In conclusion, organisms producing ESBLs and transferable AmpC ß-lactamases were widespread. Clinical laboratories must be able to detect important ß-lactamases to ensure optimal patient care and infection control.

* Corresponding author. Mailing address: Center for Research in Anti-Infectives and Biotechnology (CRAB), Department of Medical Microbiology & Immunology, School of Medicine, Creighton University Medical Center, 2500 California Plaza, Omaha, NE 68178. Phone: (402) 280-4096. Fax: (402) 280-1875. E-mail: kstaac{at}creighton.edu.

Journal of Clinical Microbiology, September 2006, p. 3318-3324, Vol. 44, No. 9
0095-1137/06/$08.00+0     doi:10.1128/JCM.00756-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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