title: Evaluation of an accelerated protocol for detection of extended-spectrum beta-lactamase-producing gram-negative bacilli from positive blood cultures.
abstract: We evaluated a protocol for the accelerated detection of extended-spectrum beta-lactamases (ESBLs) in gram-negative bloodstream pathogens. Two hundred eighty-three blood culture bottles were subjected to direct ESBL testing by inoculating samples directly from blood culture bottles onto agar plates containing cefotaxime and ceftazidime disks, with and without clavulanate. Standard ESBL testing in accordance with the NCCLS guidelines after subculturing on agar plates was performed in parallel. Results of the direct ESBL testing were reported 2.3 days sooner and were comparable to those of the standard NCCLS method with sensitivity, specificity, and positive and negative predictive values of 100, 98, 94, and 100%, respectively.
authors.affiliation: Molecular Epidemiology Laboratory, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman St., Tel-Aviv 64239, Israel. shiri_nv@tasmc.health.gov.il
authors.forename: Shiri
authors.initials: S
authors.lastname: Navon-Venezia
authors.forename: Azita
authors.initials: A
authors.lastname: Leavitt
authors.forename: Ronen
authors.initials: R
authors.lastname: Ben-Ami
authors.forename: Yuval
authors.initials: Y
authors.lastname: Aharoni
authors.forename: Mitchell J
authors.initials: MJ
authors.lastname: Schwaber
authors.forename: David
authors.initials: D
authors.lastname: Schwartz
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Carmeli
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001769:Blood / Q000382:microbiology*; D002439:Cefotaxime / Q000494:pharmacology; D002442:Ceftazidime / Q000494:pharmacology; D018550:Cephalosporin Resistance; D003470:Culture Media; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000201:enzymology / Q000254:growth & development / Q000302:isolation & purification*; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D003470:Culture Media; D002442:Ceftazidime; D001618:beta-Lactamases; D002439:Cefotaxime