title: Determining the optimal ceftriaxone MIC for triggering extended-spectrum β-lactamase confirmatory testing.
abstract: As routine testing of clinical isolates for extended-spectrum β-lactamase (ESBL) production (screen plus phenotypic confirmatory testing) is no longer required by the Clinical and Laboratory Standards Institute (CLSI), a number of clinical microbiology laboratories use ceftriaxone MICs as a proxy means of identifying bacteria as potential ESBL producers. Data from 1,386 clinical isolates suggest that a ceftriaxone MIC cutoff of 8 μg/ml is an excellent predictor of ESBL production, with a positive predictive value and negative predictive value approaching 100% and 99.5%, respectively.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Yanjie
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Pathology, Division of Medical Microbiology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
authors.forename: Karen C
authors.initials: KC
authors.lastname: Carroll
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Cosgrove
authors.affiliation: Department of Pediatrics, Division of Infectious Diseases, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA ptamma1@jhmi.edu.
authors.forename: Pranita D
authors.initials: PD
authors.lastname: Tamma
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects* / Q000201:enzymology*; D002443:Ceftriaxone / Q000494:pharmacology*; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods; D011237:Predictive Value of Tests; D001618:beta-Lactamases / Q000032:analysis*
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D001618:beta-Lactamases
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