Prevalence of extended-spectrum beta-lactamase-producing Enterobacter cloacae in the Asia-Pacific region: results from the SENTRY Antimicrobial Surveillance Program, 1998 to 2001.
Enterobacter cloacae strains from hospitalized patients with a range of infections were collected by 17 laboratories in the Asia-Pacific region and South Africa. Isolates for which ceftriaxone MICs were above 1 microg/ml and/or ceftazidime MICs were above 2 microg/ml, as well as 46 strains for which ceftriaxone and/or ceftazidime MICs were at or below these values, were screened for levels of extended-spectrum beta-lactamase (ESBL) production through the use of broth microdilution for the detection of clavulanate enhancement of the activity of ceftriaxone, ceftazidime, and cefepime. Of the isolates examined, ceftriaxone and/or ceftazidime had elevated MICs for 44%, of which 36% were ESBL positive. ESBL-positive strains were commonly susceptible to piperacillin-tazobactam and more frequently resistant to several other antimicrobials studied. A cefepime MIC above 0.25 microg/ml had the highest sensitivity (100%) and specificity (74%) for predicting the presence of an ESBL.
Bell
J M
JM
Microbiology and Infectious Diseases Department, Women's and Children's Hospital, Adelaide, Australia. bellj@mail.wch.sa.gov.au
Turnidge
J D
JD
Jones
R N
RN
D001208:Asia / Q000453:epidemiology; D002511:Cephalosporins / Q000494:pharmacology; D019818:Clavulanic Acid / Q000494:pharmacology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D016972:Enterobacter cloacae / Q000187:drug effects* / Q000201:enzymology*; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology; D004791:Enzyme Inhibitors / Q000494:pharmacology; D006801:Humans; D008826:Microbial Sensitivity Tests; D010139:Pacific Islands / Q000453:epidemiology; D010406:Penicillins / Q000494:pharmacology; D010641:Phenotype; D013019:South Africa / Q000453:epidemiology; D065093:beta-Lactamase Inhibitors; D001618:beta-Lactamases / Q000378:metabolism*
D002511:Cephalosporins; D004791:Enzyme Inhibitors; D010406:Penicillins; D065093:beta-Lactamase Inhibitors; D019818:Clavulanic Acid; D001618:beta-Lactamases