Korean J Lab Med.  2009 Feb;29(1):35-40. 10.3343/kjlm.2009.29.1.35.

Evaluation of the MicroScan NegCombo Panel Type 44 for Detection of Extended-Spectrum beta-Lactamase among Clinical Isolates of Escherichia coli, Klebsiella species, and Proteus mirabilis

• Ko SY
• Chung JW
• Song AJ
• Yoon NS
• Sung H
• Kim MN

• KMID: 1781591
• DOI: http://doi.org/10.3343/kjlm.2009.29.1.35

Abstract

BACKGROUND: Accurate and rapid detection of extended-spectrum beta-lactamases (ESBLs) is important in guiding proper antimicrobial therapy for infected patients. We evaluated the performance of MicroScan NegCombo Type 44 panel (Dade Behring, USA), which was developed to confirm ESBL-producing Enterobacteriaceae using ceftazidime/clavulanate and cefotaxime/clavulanate.
METHODS
From August 30 to September 20, 2007, 206 non-duplicate clinical isolates, including 106 Escherichia coli, 81 Klebsiella pneumoniae, 11 Klebsiella oxytoca, and 8 Proteus mirabilis were subcultured and tested with Type 32 and Type 44 panels. The results were compared with those of the CLSI phenotypic confirmatory test (CLSI-PCT) and disk approximation test (DAT). Isolates not susceptible to cefotetan or flagged as "Possible ESBL, unable to interpret confirm test (Possible ESBL)" on Type 44 panel were tested with boronic acid disks to confirm AmpC beta-lactamases (AmpC) production.
RESULTS
Of the 206 isolates tested, 44 (21.4%) produced ESBL by CLSI-PCT or DAT, including 27 E. coli, 14 K. pneumoniae, 2 K. oxytoca, and 1 P. mirabilis. Thirty-eight isolates flagged as "Confirmed ESBL" on Type 44 panel were all confirmed as ESBL-producers. Of 14 K. pneumoniae flagged as "Possible ESBL", 6 were confirmed as ESBL and AmpC co-producers and 8 as AmpC-producers.
CONCLUSIONS
Type 44 panel showed an excellent performance in detecting ESBL-producing E. coli, Klebsiella spp., and P. mirabilis. When flagged as "Confirmed ESBL", no other confirmatory test was necessary to report as ESBL; however, "Possible ESBL" required a differential test for AmpC production.

Keyword

Extended-spectrum beta-lactamases; NegCombo Type 44; plasmid-mediated AmpC beta-lactamases

MeSH Terms

Bacterial Proteins/*biosynthesis
Cefotetan/pharmacology
Disk Diffusion Antimicrobial Tests
Drug Resistance, Bacterial
Escherichia coli/*enzymology/isolation & purification
Humans
Klebsiella/*enzymology/isolation & purification
Proteus mirabilis/*enzymology/isolation & purification
Reagent Kits, Diagnostic
Sensitivity and Specificity
beta-Lactamases/*biosynthesis

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