title: [Evaluation of the MicroScan NegCombo panel Type 44 for detection of extended-spectrum beta-lactamase among clinical isolates of Escherichia coli, Klebsiella species, and Proteus mirabilis].
abstract: BACKGROUND
  Accurate and rapid detection of extended-spectrum beta-lactamases (ESBLs) is important in guiding proper antimicrobial therapy for infected patients. We evaluated the performance of MicroScan NegCombo Type 44 panel (Dade Behring, USA), which was developed to confirm ESBL-producing Enterobacteriaceae using ceftazidime/clavulanate and cefotaxime/clavulanate.
  
  
  METHODS
  From August 30 to September 20, 2007, 206 non-duplicate clinical isolates, including 106 Escherichia coli, 81 Klebsiella pneumoniae, 11 Klebsiella oxytoca, and 8 Proteus mirabilis were subcultured and tested with Type 32 and Type 44 panels. The results were compared with those of the CLSI phenotypic confirmatory test (CLSI-PCT) and disk approximation test (DAT). Isolates not susceptible to cefotetan or flagged as "Possible ESBL, unable to interpret confirm test (Possible ESBL)" on Type 44 panel were tested with boronic acid disks to confirm AmpC beta-lactamases (AmpC) production.
  
  
  RESULTS
  Of the 206 isolates tested, 44 (21.4%) produced ESBL by CLSI-PCT or DAT, including 27 E. coli, 14 K. pneumoniae, 2 K. oxytoca, and 1 P. mirabilis. Thirty-eight isolates flagged as "Confirmed ESBL" on Type 44 panel were all confirmed as ESBL-producers. Of 14 K. pneumoniae flagged as "Possible ESBL", 6 were confirmed as ESBL and AmpC co-producers and 8 as AmpC-producers.
  
  
  CONCLUSIONS
  Type 44 panel showed an excellent performance in detecting ESBL-producing E. coli, Klebsiella spp., and P. mirabilis. When flagged as "Confirmed ESBL", no other confirmatory test was necessary to report as ESBL; however, "Possible ESBL" required a differential test for AmpC production.
authors.affiliation: Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
authors.forename: Sun-Young
authors.initials: SY
authors.lastname: Ko
authors.forename: Jae-Woo
authors.initials: JW
authors.lastname: Chung
authors.forename: Ah Jin
authors.initials: AJ
authors.lastname: Song
authors.forename: Nam-Surp
authors.initials: NS
authors.lastname: Yoon
authors.forename: Heungsup
authors.initials: H
authors.lastname: Sung
authors.forename: Mi-Na
authors.initials: MN
authors.lastname: Kim
mesh_terms: D001426:Bacterial Proteins / Q000096:biosynthesis*; D015313:Cefotetan / Q000494:pharmacology; D052978:Disk Diffusion Antimicrobial Tests; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000201:enzymology* / Q000302:isolation & purification; D006801:Humans; D007709:Klebsiella / Q000201:enzymology* / Q000302:isolation & purification; D011513:Proteus mirabilis / Q000201:enzymology* / Q000302:isolation & purification; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D001426:Bacterial Proteins; D011933:Reagent Kits, Diagnostic; D015313:Cefotetan; C048795:AmpC beta-lactamases; D001618:beta-Lactamases