title: Cefotaxime-resistant Citrobacter freundii in isolates from blood in a tertiary teaching hospital in Northern Taiwan.
abstract: 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.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Mackay Memorial Hospital, Taipei, Taiwan. cpliu@ms1.mmh.org.tw
authors.forename: Chang-Pan
authors.initials: CP
authors.lastname: Liu
authors.forename: Li-Chuan
authors.initials: LC
authors.lastname: Weng
authors.forename: Hsiang-Kuang
authors.initials: HK
authors.lastname: Tseng
authors.forename: Nai-Yu
authors.initials: NY
authors.lastname: Wang
authors.forename: Chun-Ming
authors.initials: CM
authors.lastname: Lee
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D002439:Cefotaxime