title: [Importance of quality control for the detection of β-lactam antibiotic resistance in Enterobacteriaceae].
abstract: β-lactam antimicrobial agents are frequently used to treat infections caused by Enterobacteriaceae. The main mechanism of resistance to these antibiotics is the production of certain enzymes, collectively named β-lactamases. Due to their substrate profile and their epidemiological implications, the most clinically important β-lactamases are extended-spectrum β-lactamases, class C β-lactamases and carbapenemases. Phenotypic detection of these enzymes may be complicated and is based on the use of specific inhibitors of each β-lactamase and on the loss of activity on some β-lactam indicators. Various international committees postulate that it is no longer necessary to interpret the susceptibility results or determine the mechanism of resistance. Several critics disagree, however, and consider that susceptibility results should be interpreted until more data are available on the clinical efficacy of treatment with β-lactams. Given these methodological difficulties and constant changes in the interpretation criteria, we consider that training and external quality controls are essential to keep updated in this field. For learning purposes, these external quality controls should always be accompanied by a review of the results and methodology used, and the analysis of errors. In this paper we review and contextualize all the aspects related to the detection and interpretation of these β-lactamases.
authors.affiliation: Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
authors.forename: Alba
authors.initials: A
authors.lastname: Rivera
authors.affiliation: Servicio de Microbiología, Hospital Vall d'Hebron, Barcelona, España; Universitat Autònoma de Barcelona, España; Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, España.
authors.forename: Nieves
authors.initials: N
authors.lastname: Larrosa
authors.affiliation: Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, Barcelona, España; Universitat Autònoma de Barcelona, España; Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, España; Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Barcelona, España.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Mirelis
authors.affiliation: Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, Barcelona, España; Universitat Autònoma de Barcelona, España; Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, España; Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Barcelona, España. Electronic address: fnavarror@santpau.cat.
authors.forename: Ferran
authors.initials: F
authors.lastname: Navarro
mesh_terms: D004755:Enterobacteriaceae / Q000187:drug effects*; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000592:standards; D011786:Quality Control; D018440:beta-Lactam Resistance
keywords: AmpC β-lactamases; Antimicrobial resistance; Carbapenemasas; Carbapenemases; Control de calidad; Quality control; Resistencia antimicrobiana; β-lactamasas; β-lactamasas AmpC; β-lactamases