Abstract
Objective: We analyzed the effects of different cefepime MIC breakpoints on Enterobacteriaceae cefepime susceptibility and the presence of AmpC and extended-spectrum β-lactamase (ESBL) genes within the cefepime MIC interpretative categories. Methods: Using Enterobacteriaceae susceptibility data from 2013 comparisons of MIC breakpoints were performed using Pearson's chi-squared test. Molecular testing on a subset of isolates was done. Results: Among 3784 non-duplicate clinical isolates, cefepime susceptibility decreased from 97.6% to 96.1% to 93.7% for CLSI 2013, CLSI 2014, and EUCAST 2011, respectively. In ceftriaxone non-susceptible isolates, cefepime susceptibility decreased from 79% to 66% (P <. 0.0001) using CLSI 2013 and 2014, respectively, which was greater and statistically significant for Escherichia coli and Klebsiella spp. but not for Enterobacter spp. (P = 0.06). Isolates with MIC ≤1. μg/mL more often harbored AmpC (77%) than ESBL (18%) genes. Conclusions: Lower cefepime MIC breakpoints decrease cefepime susceptibility for isolates harboring ESBLs, while sparing the majority of those with AmpCs.
| Original language | English (US) |
|---|---|
| Journal | Diagnostic Microbiology and Infectious Disease |
| DOIs | |
| State | Accepted/In press - 2017 |
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All Science Journal Classification (ASJC) codes
- Microbiology (medical)
- Infectious Diseases
Cite this
Impact of CLSI and EUCAST Cefepime breakpoint changes on the susceptibility reporting for Enterobacteriaceae. / Bork, Jacqueline T.; Heil, Emily L.; Leekha, Surbhi; Fowler, Randal C.; Hanson, Nancy D.; Majumdar, Anjali; Johnson, J. Kristie.
In: Diagnostic Microbiology and Infectious Disease, 2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Impact of CLSI and EUCAST Cefepime breakpoint changes on the susceptibility reporting for Enterobacteriaceae
AU - Bork, Jacqueline T.
AU - Heil, Emily L.
AU - Leekha, Surbhi
AU - Fowler, Randal C.
AU - Hanson, Nancy D.
AU - Majumdar, Anjali
AU - Johnson, J. Kristie
PY - 2017
Y1 - 2017
N2 - Objective: We analyzed the effects of different cefepime MIC breakpoints on Enterobacteriaceae cefepime susceptibility and the presence of AmpC and extended-spectrum β-lactamase (ESBL) genes within the cefepime MIC interpretative categories. Methods: Using Enterobacteriaceae susceptibility data from 2013 comparisons of MIC breakpoints were performed using Pearson's chi-squared test. Molecular testing on a subset of isolates was done. Results: Among 3784 non-duplicate clinical isolates, cefepime susceptibility decreased from 97.6% to 96.1% to 93.7% for CLSI 2013, CLSI 2014, and EUCAST 2011, respectively. In ceftriaxone non-susceptible isolates, cefepime susceptibility decreased from 79% to 66% (P <. 0.0001) using CLSI 2013 and 2014, respectively, which was greater and statistically significant for Escherichia coli and Klebsiella spp. but not for Enterobacter spp. (P = 0.06). Isolates with MIC ≤1. μg/mL more often harbored AmpC (77%) than ESBL (18%) genes. Conclusions: Lower cefepime MIC breakpoints decrease cefepime susceptibility for isolates harboring ESBLs, while sparing the majority of those with AmpCs.
AB - Objective: We analyzed the effects of different cefepime MIC breakpoints on Enterobacteriaceae cefepime susceptibility and the presence of AmpC and extended-spectrum β-lactamase (ESBL) genes within the cefepime MIC interpretative categories. Methods: Using Enterobacteriaceae susceptibility data from 2013 comparisons of MIC breakpoints were performed using Pearson's chi-squared test. Molecular testing on a subset of isolates was done. Results: Among 3784 non-duplicate clinical isolates, cefepime susceptibility decreased from 97.6% to 96.1% to 93.7% for CLSI 2013, CLSI 2014, and EUCAST 2011, respectively. In ceftriaxone non-susceptible isolates, cefepime susceptibility decreased from 79% to 66% (P <. 0.0001) using CLSI 2013 and 2014, respectively, which was greater and statistically significant for Escherichia coli and Klebsiella spp. but not for Enterobacter spp. (P = 0.06). Isolates with MIC ≤1. μg/mL more often harbored AmpC (77%) than ESBL (18%) genes. Conclusions: Lower cefepime MIC breakpoints decrease cefepime susceptibility for isolates harboring ESBLs, while sparing the majority of those with AmpCs.
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U2 - 10.1016/j.diagmicrobio.2017.08.020
DO - 10.1016/j.diagmicrobio.2017.08.020
M3 - Article
JO - Diagnostic Microbiology and Infectious Disease
JF - Diagnostic Microbiology and Infectious Disease
SN - 0732-8893
ER -