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Journal of Clinical Microbiology, February 2007, p. 501-505, Vol. 45, No. 2
0095-1137/07/$08.00+0     doi:10.1128/JCM.02221-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Evaluation of a New Selective Chromogenic Agar Medium for Detection of Extended-Spectrum ß-Lactamase-Producing Enterobacteriaceae{triangledown}

Youri Glupczynski,* Catherine Berhin, Caroline Bauraing, and Pierre Bogaerts

Laboratoire de Bactériologie, Cliniques Universitaires UCL de Mont-Godinne, B-5530 Yvoir, Belgique

Received 30 October 2006/ Accepted 8 December 2006

A novel chromogenic agar medium (ESBL-Bx; bioMérieux, Marcy l'Etoile, France) was compared to MacConkey agar supplemented with 2 mg ceftazidime/liter (MCKC) for the selective isolation and presumptive identification of extended-spectrum ß-lactamase (ESBL)-producing Enterobacteriaceae directly from clinical samples. Of a total of 644 clinical specimens (including 551 fecal samples), 496 yielded no growth and 148 yielded growth on one or both media. Overall, 44 ESBL-producing Enterobacteriaceae strains (Escherichia coli [n = 17], Enterobacter aerogenes [n = 17], Klebsiella spp. [n = 5], and Citrobacter freundii [n = 5]) were isolated from 37 specimens by a combination of both methods after 18 to 24 h of incubation. The sensitivities were 97.7 and 84.1% for ESBL-Bx and MCKC, respectively, with 43 ESBL-positive strains isolated as colored colonies from 36 specimens on ESBL-Bx versus 37 ESBL-positive organisms isolated from 32 specimens on MCKC. The specificities by specimens were 89 and 91% for ESBL-Bx and MCKC, respectively. On either one of the two media, natural AmpC-hyperproducing Enterobacter spp. (n = 25) and Citrobacter spp. (n = 14) were the most common false positives as well as non-ESBL-producing Klebsiella oxytoca (n = 18) on ESBL-Bx and Morganella morganii (n = 10) on MCKC. We conclude that ESBL-Bx is a sensitive and specific medium for the isolation of ESBL-producing Enterobacteriaceae from clinical samples. The main advantages of ESBL-Bx over MCKC reside in its chromogenic character and its sensitivity and selectivity, which enabled the recovery and presumptive identification of most ESBL-producing Enterobacteriaceae within 24 h and reduced by 27% the need for unnecessary identification and confirmation of ESBL testing when disregarding all colorless colonies growing on this medium.

* Corresponding author. Mailing address: Laboratoire de Bactériologie, Cliniques Universitaires UCL de Mont-Godinne, 1, Av. Dr Gaston Thérasse, B-5530 Yvoir, Belgium. Phone: 32-81-42-32-45. Fax: 32-81-42-32-46. E-mail: youri.glupczynski{at}skynet.be.

{triangledown} Published ahead of print on 20 December 2006.

Journal of Clinical Microbiology, February 2007, p. 501-505, Vol. 45, No. 2
0095-1137/07/$08.00+0     doi:10.1128/JCM.02221-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.



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