Comparison of European Committee on Antimicrobial Susceptibility Testing (EUCAST) and CLSI screening parameters for the detection of extended-spectrum β-lactamase production in clinical Enterobacteriaceae isolates
| Autor: | Silke Polsfuss, Michael Hombach, Jacqueline Giger, Guido V. Bloemberg, Vera Meyer |
|---|---|
| Přispěvatelé: | University of Zurich, Hombach, Michael |
| Rok vydání: | 2011 |
| Předmět: |
Microbiology (medical)
Cefotaxime Cefepime Ceftazidime 610 Medicine & health Microbial Sensitivity Tests Cefpodoxime beta-Lactams 2726 Microbiology (medical) beta-Lactamases Microbiology Enterobacteriaceae Clavulanic acid parasitic diseases polycyclic compounds 2736 Pharmacology (medical) Medicine Humans Mass Screening Pharmacology (medical) Pharmacology 10179 Institute of Medical Microbiology business.industry Breakpoint Enterobacteriaceae Infections 2725 Infectious Diseases biochemical phenomena metabolism and nutrition Amoxicillin bacterial infections and mycoses Anti-Bacterial Agents 3004 Pharmacology Infectious Diseases Ceftriaxone 570 Life sciences biology bacteria business medicine.drug |
| Zdroj: | The Journal of antimicrobial chemotherapy. 67(1) |
| ISSN: | 1460-2091 |
| Popis: | Objectives To compare the performance of European Committee on Antimicrobial Susceptibility Testing (EUCAST) and CLSI breakpoints following their revision in 2010, for the detection of extended-spectrum β-lactamase (ESBL) production in Enterobacteriaceae. Methods 236 well-characterized clinical isolates (including 118 ESBL producers) were investigated by antibiotic disc testing with cefpodoxime, ceftriaxone, cefepime, cefotaxime EUCAST (5 μg/disc), ceftazidime EUCAST (10 μg/disc), cefotaxime CLSI (30 μg/disc) and ceftazidime CLSI (30 μg/disc) with the Kirby-Bauer method. Additionally, synergy phenomena were recorded between amoxicillin/clavulanic acid discs (20/10 μg/disc) and cefepime (30 μg/disc), EUCAST cefotaxime (5 μg/disc), EUCAST ceftazidime (10 μg/disc), CLSI cefotaxime (30 μg/disc) and CLSI ceftazidime [30 μg/disc; disc approximation method (DAM)]. Results Overall sensitivity of the cefotaxime EUCAST non-susceptible breakpoint equalled sensitivity of the cefotaxime CLSI ESBL screening breakpoint (99.2%). With the ceftazidime EUCAST non-susceptible breakpoint, 27/118 ESBL-producing isolates were not detected, whereas the ceftazidime CLSI ESBL screening breakpoint missed 41/118 ESBL-producing isolates. For cefpodoxime the resistant EUCAST breakpoint showed higher sensitivity for ESBL detection compared with the CLSI ESBL screening breakpoint/disc content (100% versus 98.3%, respectively). Sensitivities of ceftazidime and cefotaxime DAM with CLSI or EUCAST disc contents were comparable (sensitivities ranging from 84.7% to 89.8%). DAM with cefepime displayed the highest overall sensitivity (96.6%). In AmpC-producing isolates, synergy of amoxicillin/clavulanic acid with cefepime showed sensitivity and specificity for ESBL detection of 100% and 97.4%, respectively. Conclusions EUCAST non-susceptible breakpoints for ceftazidime and cefpodoxime detect more ESBL-producing Enterobacteriaceae isolates compared with corresponding CLSI ESBL screening breakpoints. Implementation of the cefepime DAM can facilitate ESBL screening, especially in strains producing an AmpC β-lactamase since the test shows high sensitivity and specificity |
| Databáze: | OpenAIRE |
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