title: Metallo-beta-lactamase or extended-spectrum beta-lactamase: a wolf in sheep's clothing.
abstract: Diagnostic algorithms in commonly used automated bacterial identification systems fail to reliably identify a metallo-beta-lactamase in the Enterobacteriaceae. Misidentification as an extended-spectrum beta-lactamase may result in inappropriate dismissal of drugs such as aztreonam in favor of carbapenems, which may in turn select for a highly carabapenem resistant phenotype.
authors.affiliation: Centre for Infectious Diseases and Microbiology, University of Sydney, Westmead Hospital, Westmead, NSW 2145, Australia.
authors.forename: Björn A
authors.initials: BA
authors.lastname: Espedido
authors.forename: Lee C
authors.initials: LC
authors.lastname: Thomas
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Iredell
mesh_terms: D000465:Algorithms; D001331:Automation; D015373:Bacterial Typing Techniques; D015780:Carbapenems / Q000494:pharmacology; D003227:Conjugation, Genetic; D003951:Diagnostic Errors; D004755:Enterobacteriaceae / Q000145:classification* / Q000187:drug effects / Q000201:enzymology*; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000295:instrumentation* / Q000379:methods*; D011933:Reagent Kits, Diagnostic; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D015780:Carbapenems; D011933:Reagent Kits, Diagnostic; C425142:beta-lactamase IMP-4; D001618:beta-Lactamases