title: Prevalence, microbiology, and clinical characteristics of extended-spectrum beta-lactamase-producing Enterobacter spp., Serratia marcescens, Citrobacter freundii, and Morganella morganii in Korea.
abstract: We examined the prevalence and characteristics of extended-spectrum beta-lactamase (ESBL)-producing clinical isolates among Enterobacter spp., Serratia marcescens, Citrobacter freundii, and Morganella morganii, and evaluated screening criteria, clinical characteristics and outcomes of infections caused by ESBL-producing organisms. Between January and June 2005, a total of 493 nonduplicate consecutive isolates were collected at Asan Medical Center, a 2,300-bed tertiary hospital in Seoul, Republic of Korea. Fifty isolates (10.1%) were positive for phenotypical ESBL-test. The positive rate of phenotypical ESBL-test in Enterobacter spp., S. marcescens, C. freundii, and M. morganii was 12.8%, 12.4%, 4.9%, and 0% respectively. SHV-12 (18 isolates), CTX-M-9 (17 isolates), and TEM-52 (five isolates) were the most prevalent ESBL types. The ESBL in 17 strains could not be identified. As an ESBL screening criterion, the cefepime MIC >or=1 microg/ml had the highest sensitivity (0.84) and specificity (0.87). Half of the ESBL-producing isolates (25/50) were judged as pathogens. Cholangitis (ten cases), and pneumonia (six cases) were the most common infections. The overall mortality was 12.0%.
authors.affiliation: Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Pungnap-dong, Songpa-gu, Seoul, 138-736, South Korea.
authors.forename: S-H
authors.initials: SH
authors.lastname: Choi
authors.forename: J E
authors.initials: JE
authors.lastname: Lee
authors.forename: S J
authors.initials: SJ
authors.lastname: Park
authors.forename: M-N
authors.initials: MN
authors.lastname: Kim
authors.forename: E J
authors.initials: EJ
authors.lastname: Choo
authors.forename: Y G
authors.initials: YG
authors.lastname: Kwak
authors.forename: J-Y
authors.initials: JY
authors.lastname: Jeong
authors.forename: J H
authors.initials: JH
authors.lastname: Woo
authors.forename: N J
authors.initials: NJ
authors.lastname: Kim
authors.forename: Y S
authors.initials: YS
authors.lastname: Kim
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D001426:Bacterial Proteins / Q000235:genetics* / Q000378:metabolism; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects / Q000235:genetics; D004755:Enterobacteriaceae / Q000145:classification / Q000187:drug effects* / Q000235:genetics; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015995:Prevalence; D012372:ROC Curve; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism
chemical_list: D001426:Bacterial Proteins; C048795:AmpC beta-lactamases; D001618:beta-Lactamases