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[Detection methods for drug-resistant bacteria in routine examination--ESBL]
1Department of Microbiology, Kitasato University School of Medicine.
Rinsho Byori. the Japanese Journal of Clinical Pathology
|May 11, 2000
Summary
Extended-spectrum beta-lactamases (ESBLs) cause resistance in K. pneumoniae and E. coli. This study details optimal methods for confirming ESBL-producing isolates, even those with lower resistance levels that may not meet standard resistance breakpoints.
Area of Science:
- Microbiology
- Clinical Science
- Antimicrobial Resistance
Background:
- Extended-spectrum beta-lactamases (ESBLs) are enzymes that confer resistance to critical antibiotics like cephalosporins and penicillins.
- Clinical isolates of Klebsiella pneumoniae and Escherichia coli frequently harbor ESBLs, posing a significant challenge in healthcare settings.
- Some ESBL variants exhibit reduced resistance, potentially leading to misclassification and failure to identify resistant strains using standard clinical breakpoints.
Purpose of the Study:
- To describe and validate optimal methods for the accurate confirmation of ESBL-producing bacterial isolates.
- To address the challenge of identifying ESBL-producing strains that exhibit lower-level resistance and may not meet established NCCLS resistance breakpoints.
Main Methods:
- Review and description of established microbiological techniques for detecting ESBL activity.
- Focus on phenotypic confirmation methods, including synergy testing and minimum inhibitory concentration (MIC) determination.
- Consideration of molecular methods for identifying specific ESBL genes.
Main Results:
- ESBLs confer resistance to a range of beta-lactam antibiotics, including cefotaxime, ceftazidime, and aztreonam.
- Isolates with certain ESBLs may display resistance levels below standard NCCLS breakpoints, necessitating careful confirmation.
- The described methods provide reliable confirmation of ESBL production in diverse clinical isolates.
Conclusions:
- Accurate confirmation of ESBL-producing isolates is crucial for effective patient management and infection control.
- Standard breakpoints may not capture all ESBL-producing strains, highlighting the importance of confirmatory testing.
- Implementation of optimized detection methods is recommended to improve the identification of antimicrobial resistance in K. pneumoniae and E. coli.