title: Evaluation of different phenotypic methods for detection of amp C Beta-lactamase producing bacteria in clinical isolates.
abstract: OBJECTIVE
  To compare the sensitivity and specificity of different phenotypic methods for detection of Amp C betalactamase producing bacteria.
  
  
  METHODS
  Analytical study.
  
  
  METHODS
  Department of Microbiology, Army Medical College / National University of Sciences and Technology (NUST), Islamabad, Pakistan, from June 2010 to December 2010.
  
  
  METHODS
  A total of 150 clinical isolates were screened for presence of Amp C beta-lactamase by using the cefoxitin disc. The confirmatory methods evaluated were inhibitor based assay (boronic acid), Amp C disc test and Amp C Etest. Three dimensional enzyme extract assay was used as the reference method for determining the sensitivity and specificity.
  
  
  RESULTS
  Among the total isolates tested, 62.8% bacteria showed the presence of Amp C beta-lactamase by standard three dimensional enzyme extract assay. Among the three methods compared, boronic acid disk test found out to be highly sensitive (88%) and specific (92%) for the detection of Amp C beta-lactamase producing bacteria.
  
  
  CONCLUSIONS
  Detection of Amp C production is crucial in order to establish the antibiotic therapy and to attain the favourable clinical outcomes. Implementation of simple tests like boronic acid disk tests in the laboratories will help to alleviate the spread of Amp C beta-lactamase harboring organisms.
authors.affiliation: Department of Microbiology, Army Medical College, National University of Sciences and Technology (NUST), Islamabad.
authors.forename: Afreenish
authors.initials: A
authors.lastname: Hassan
authors.forename: Javaid
authors.initials: J
authors.lastname: Usman
authors.forename: Fatima
authors.initials: F
authors.lastname: Kaleem
authors.forename: Maria Mushtaq
authors.initials: MM
authors.lastname: Gill
authors.forename: Ali
authors.initials: A
authors.lastname: Khalid
authors.forename: Muhammad
authors.initials: M
authors.lastname: Iqbal
authors.forename: Paul
authors.initials: P
authors.lastname: Ingram
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification*; D001426:Bacterial Proteins / Q000096:biosynthesis* / Q000235:genetics / Q000302:isolation & purification*; D001888:Boric Acids / Q000378:metabolism; D002440:Cefoxitin / Q000378:metabolism / Q000494:pharmacology; D004269:DNA, Bacterial / Q000235:genetics; D052978:Disk Diffusion Antimicrobial Tests / Q000379:methods*; D024881:Drug Resistance, Bacterial; D004791:Enzyme Inhibitors / Q000494:pharmacology; D006801:Humans; D010641:Phenotype; D012680:Sensitivity and Specificity; D001618:beta-Lactamases / Q000096:biosynthesis* / Q000235:genetics / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001888:Boric Acids; D004269:DNA, Bacterial; D004791:Enzyme Inhibitors; D002440:Cefoxitin; C048795:AmpC beta-lactamases; D001618:beta-Lactamases