Korean J Clin Pathol.  1999 Apr;19(2):196-201.

Evaluation of the Method to Screen Isolates of Extended-Spectrum -Lactamase-Producing Klebsiella pneumoniae and Escherichia coli Using Cefpodoxime Disk

• Song W
• Kim HT
• Lee KM

Abstract

BACKGROUND
The prevalence of extended-spectrum -lactamase (ESBL)-producing Klebsiella pneumoniae and Escherichia coli has been increased in Korea, but the testing and reporting ESBL-mediated resistance remains unclear. We undertook a study to evaluate the method to screen isolates of ESBL-producing K. pneumoniae and E. coli using cefpodoxime disk.
METHODS
Fifty-eight strains of K. pneumoniae and 28 strains of E. coli were tested for production of ESBLs by the double disk synergy test. Susceptibility to cefpodoxime, ceftazidime, cefotaxime, and aztreonam was determined by disk diffusion method.
RESULTS
All strains that produced ESBLs were resistant to cefpodoxime, whereas those that not produced ESBLs were susceptible (97%) to this agents. The disk diffusion test exhibited 100% sensitivity and 97% specificity when NCCLS conventional interpretive criteria were used. All other oxyimino- -lactam agents tested were inferior discriminators between the two groups of organisms. When NCCLS ESBL interpretive criteria were used, the disk diffusion test using cefpodoxime exhibited 100% sensitivity and 83% specificity.
CONCLUSIONS
Routine disk diffusion susceptibility test with cefpodoxime disk (10g) can be used to detect strains of ESBL-producing K. pneumoniae and E. coli without include supplemental testing for ESBL production.

Keyword

Extended-spectrum-lactamase (ESBL); Klebsiella pneumoniae; Escherichia coli; Cefpodoxime disk; Double disk synergy test

MeSH Terms

Aztreonam
Cefotaxime
Ceftazidime
Diffusion
Escherichia coli*
Escherichia*
Klebsiella pneumoniae*
Klebsiella*
Korea
Pneumonia
Prevalence
Sensitivity and Specificity
Aztreonam
Cefotaxime
Ceftazidime