title: A rapid and simple method to detect ESBL in Enterobacter cloacae based on MIC of cefepime.
abstract: BACKGROUND
  The aim of this study was to identify a rapid and simple phenotypic method for extended-spectrum β-lactamase (ESBL) detection in Enterobacter cloacae.
  
  
  METHODS
  A total of 79 consecutive, non-repeated samples of E. cloacae were evaluated. Four phenotypic methods were applied for ESBL detection, results were compared to multiplex polymerase chain reaction (PCR) as the gold standard reference method: 1) ceftazidime and cefotaxime disks with and without clavulanate, both with boronic acid added; 2) disk approximation using cefepime and amoxicillin/clavulanate; 3) ESBL screening by minimum inhibitory concentration (MIC) ≥ 16µg/mL and 4) by MIC ≥ 2µg/mL for cefepime.
  
  
  RESULTS
  Method 4 showed the best combination of sensitivity (100%) and specificity (94%).
  
  
  CONCLUSIONS
  MIC ≥ 2µg/mL for cefepime would be very useful for the phenotypic detection of ESBL in samples of E. cloacae.
authors.affiliation: Departamento de Ciências Básicas da Saúde, Universidade Estadual de Maringá, Maringá, Maringá,, Paraná, Brazil.
authors.forename: Marina de Souza
authors.initials: Mde S
authors.lastname: Bastos
authors.affiliation: Departamento de Ciências Básicas da Saúde, Universidade Estadual de Maringá, Maringá, Maringá,, Paraná, Brazil.
authors.forename: Thatiany Cevallos
authors.initials: TC
authors.lastname: Menegucci
authors.affiliation: Departamento de Ciências Básicas da Saúde, Universidade Estadual de Maringá, Maringá, Maringá,, Paraná, Brazil.
authors.forename: Rafael Renato Brondani
authors.initials: RR
authors.lastname: Moreira
authors.affiliation: Departamento de Ciências Básicas da Saúde, Universidade Estadual de Maringá, Maringá, Maringá,, Paraná, Brazil.
authors.forename: Lourdes Botelho
authors.initials: LB
authors.lastname: Garcia
authors.affiliation: Departamento de Ciências Básicas da Saúde, Universidade Estadual de Maringá, Maringá, Maringá,, Paraná, Brazil.
authors.forename: Celso Luiz
authors.initials: CL
authors.lastname: Cardoso
authors.affiliation: Departamento de Ciências Básicas da Saúde, Universidade Estadual de Maringá, Maringá, Maringá,, Paraná, Brazil.
authors.forename: Maria Cristina Bronharo
authors.initials: MC
authors.lastname: Tognim
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D000077723:Cefepime; D002511:Cephalosporins / Q000494:pharmacology; D016972:Enterobacter cloacae / Q000187:drug effects / Q000201:enzymology*; D006801:Humans; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests / Q000379:methods; D010641:Phenotype; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D001618:beta-Lactamases / Q000032:analysis* / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D000077723:Cefepime; D001618:beta-Lactamases