Cefotaxime-resistant Citrobacter freundii in isolates from blood in a tertiary teaching hospital in Northern Taiwan.
From January 2002 to December 2003, 12 patients in a tertiary teaching hospital in northern Taiwan had bloodstream infections caused by Citrobacter freundii. Seven of the 12 isolates were resistant to cefotaxime. Using polymerase chain reaction and DNA sequencing, 3 of the 7 cefotaxime-resistant C. freundii isolates were found to carry extended-spectrum beta-lactamase (ESBL). AmpC beta-lactamase genes were also detected in all strains of C. freundii. All strains of C. freundii with MICs >or=4 mg/L for cefepime were positive for ESBL. Rather than performing PCR on all cefotaxime-resistant C. freundii isolates, assessment of the MIC for cefepime might be a practical way to choose between treatment with cefepime or with carbapenems.
Liu
Chang-Pan
CP
Division of Infectious Diseases, Department of Medicine, Mackay Memorial Hospital, Taipei, Taiwan. cpliu@ms1.mmh.org.tw
Weng
Li-Chuan
LC
Tseng
Hsiang-Kuang
HK
Wang
Nai-Yu
NY
Lee
Chun-Ming
CM
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002439:Cefotaxime / Q000627:therapeutic use*; D016971:Citrobacter freundii / Q000235:genetics* / Q000302:isolation & purification; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D013624:Taiwan
D000900:Anti-Bacterial Agents; D002439:Cefotaxime