1999
DOI: 10.1128/aac.43.6.1393
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Use of Microdilution Panels with and without β-Lactamase Inhibitors as a Phenotypic Test for β-Lactamase Production among Escherichia coli , Klebsiella spp., Enterobacter spp., Citrobacter freundii , and Serratia marcescens

Abstract: Over the past decade, a number of new β-lactamases have appeared in clinical isolates of Enterobacteriaceaethat, unlike their predecessors, do not confer β-lactam resistance that is readily detected in routine antibiotic susceptibility tests. Because optimal methodologies are needed to detect these important new β-lactamases, a study was designed to evaluate the ability of a panel of various β-lactam antibiotics tested alone and in combination with β-lactamase inhibitors to discriminate between the production … Show more

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Cited by 53 publications
(20 citation statements)
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“…15 Clavulanate's failure to lower MICs in ESBL producers has been hypothesized to relate in large part to its ability to induce the AmpC type b-lactamase. 16 With over 200 known ESBLs, DNA sequencing remains the gold standard for detection and identification of specific types. Both the SHV-12 and CTX-M-27 genes in our isolates were carried in plasmids.…”
Section: Discussionmentioning
confidence: 99%
“…15 Clavulanate's failure to lower MICs in ESBL producers has been hypothesized to relate in large part to its ability to induce the AmpC type b-lactamase. 16 With over 200 known ESBLs, DNA sequencing remains the gold standard for detection and identification of specific types. Both the SHV-12 and CTX-M-27 genes in our isolates were carried in plasmids.…”
Section: Discussionmentioning
confidence: 99%
“…It is quite likely that an ESBL will not be identified when cefotaxime is tested against an organism with a strong clavulanate-insensitive, cefotaxime-hydrolyzing group 1 cephalosporinase that is produced together with a weak clavulanate-sensitive, cefotaximehydrolyzing ESBL. In addition, if cefpodoxime is used in the ESBL screening test, false-positive results based upon an initial MIC of у2 mg/mL frequently are seen [30] because of high rates of cefpodoxime hydrolysis by clavulanate-insensitive group 1 cephalosporinases, as well as by ESBLs.…”
mentioning
confidence: 99%
“…Thus, the presence of an ESBL can be masked by the expression of an AmpC-type enzyme in the same strain (by masking any synergy with ESBLs) 40 . As a result, when testing for ESBL production in these organisms, we should consider using sulfones such as tazobactam and sulbactam as β-lactamase inhibitors 41 . Although the exact reasons are not completely understood, the pressure to use non-β-lactam antibiotics may be responsible for the coexistence of ESBL and AmpC.…”
Section: Discussionmentioning
confidence: 99%