title: The AmpC inhibitor, Syn2190, can be used to reveal extended-spectrum beta-lactamases in Escherichia coli.
abstract: AmpC beta-lactamases are not inhibited by clavulanic acid and could potentially mask detection of extended-spectrum beta-lactamases (ESBLs) using the Clinical and Laboratory Standards Institute confirmatory test. Syn2190 (1,5-dihydroxy-4-pyridone monobactam) selectively inhibits AmpC, but not ESBLs. Fifty-four MicroScan ESBL screen-positive strains of Escherichia coli and an unrelated group of 20 cefoxitin-nonsusceptible E. coli strains were tested with the confirmatory ceftazidime-cefotaxime-clavulanate disk method with or without 4 microg/mL of Syn2190 in the agar. Without Syn2190, 8 (14.8%) of 54 E. coli isolates and 0 of 20 cefoxitin-nonsusceptible E. coli isolates were confirmed. With Syn2190, an additional 9 (16.6%) of 54 of the MicroScan screen-positive E. coli isolates and 6 (30%) of 20 of the cefoxitin-nonsusceptible E. coli isolates were found. Multiplex polymerase chain reaction and sequence analysis confirmed the presence of the plasmid-associated beta-lactamase gene bla(CMY-2) in the 2 available MicroScan-screened E. coli isolates and in 5 of 6 of the cefoxitin-resistant group. These data suggest that in the presence of AmpC, ESBLs in E. coli may not be detected by the currently recommended confirmatory test.
authors: Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, P O Box 100275, Gainesville, FL 32610, USA.
authors: Tisha C
authors: TC
authors: Netzel
authors: Irfan
authors: I
authors: Jindani
authors: Nancy
authors: N
authors: Hanson
authors: Bradley M
authors: BM
authors: Turner
authors: L
authors: L
authors: Smith
authors: Kenneth H
authors: KH
authors: Rand
mesh_terms: D001426:Bacterial Proteins / Q000037:antagonists & inhibitors*; D004269:DNA, Bacterial / Q000235:genetics; D004791:Enzyme Inhibitors / Q000494:pharmacology; D004926:Escherichia coli / Q000201:enzymology*; D008826:Microbial Sensitivity Tests / Q000379:methods*; D008997:Monobactams / Q000494:pharmacology*; D010957:Plasmids; D065093:beta-Lactamase Inhibitors; D001618:beta-Lactamases / Q000096:biosynthesis* / Q000235:genetics
chemical_list: D001426:Bacterial Proteins; D004269:DNA, Bacterial; D004791:Enzyme Inhibitors; D008997:Monobactams; C120996:Syn 2190; D065093:beta-Lactamase Inhibitors; C048795:AmpC beta-lactamases; D001618:beta-Lactamases