Prevalence of newer β-lactamases in gram-negative clinical isolates collected in the United States from 2001 to 2002

Ellen S. Moland, Nancy D. Hanson, Jennifer A. Black, Ashfaque Hossain, Wonkeun Song, Kenneth S. Thomson

Research output: Contribution to journalArticle

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Abstract

Newer β-lactamases such as extended-spectrum β-lactamases (ESBLs), transferable AmpC β-lactamases, and carbapenemases are associated with laboratory testing problems of false susceptibility that can lead to inappropriate therapy for infected patients. Because there appears to be a lack of awareness of these enzymes, a study was conducted during 2001 to 2002 in which 6,421 consecutive, nonduplicate clinical isolates of aerobically growing gram-negative bacilli from patients at 42 intensive care unit (ICU) and 21 non-ICU sites across the United States were tested on-site for antibiotic susceptibility. From these isolates, 746 screen-positive isolates (11.6%) were referred to a research facility and investigated to determine the prevalence of ESBLs in all gram-negative isolates, transferable AmpC β-lactamases in Klebsiella pneumoniae, and carbapenemases in Enterobacteriaceae. The investigations involved phenotypic tests, isoelectric focusing, β-lactamase inhibitor studies, spectrophotometric assays, induction assays, and molecular analyses. ESBLs were detected only in Enterobacteriaceae (4.9% of all Enterobacteriaceae) and were found in species other than those currently recommended for ESBL testing by the CLSI (formerly NCCLS). These isolates occurred at 74% of the ICU sites and 43% of the non-ICU sites. Transferable AmpC β-lactamases were detected in 3.3% of K. pneumoniae isolates and at 16 of the 63 sites (25%) with no difference between ICU and non-ICU sites. Three sites submitted isolates that produced class A carbapenemases. No class B or D carbapenemases were detected. In conclusion, organisms producing ESBLs and transferable AmpC β-lactamases were widespread. Clinical laboratories must be able to detect important β-lactamases to ensure optimal patient care and infection control.

Original languageEnglish
Pages (from-to)3318-3324
Number of pages7
JournalJournal of Clinical Microbiology
Volume44
Issue number9
DOIs
StatePublished - Sep 2006

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Enterobacteriaceae
Intensive Care Units
Klebsiella pneumoniae
Isoelectric Focusing
Infection Control
Bacillus
Patient Care
Anti-Bacterial Agents
Enzymes
Research
Therapeutics

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Microbiology

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Prevalence of newer β-lactamases in gram-negative clinical isolates collected in the United States from 2001 to 2002. / Moland, Ellen S.; Hanson, Nancy D.; Black, Jennifer A.; Hossain, Ashfaque; Song, Wonkeun; Thomson, Kenneth S.

In: Journal of Clinical Microbiology, Vol. 44, No. 9, 09.2006, p. 3318-3324.

Research output: Contribution to journalArticle

Moland, Ellen S. ; Hanson, Nancy D. ; Black, Jennifer A. ; Hossain, Ashfaque ; Song, Wonkeun ; Thomson, Kenneth S. / Prevalence of newer β-lactamases in gram-negative clinical isolates collected in the United States from 2001 to 2002. In: Journal of Clinical Microbiology. 2006 ; Vol. 44, No. 9. pp. 3318-3324.
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abstract = "Newer β-lactamases such as extended-spectrum β-lactamases (ESBLs), transferable AmpC β-lactamases, and carbapenemases are associated with laboratory testing problems of false susceptibility that can lead to inappropriate therapy for infected patients. Because there appears to be a lack of awareness of these enzymes, a study was conducted during 2001 to 2002 in which 6,421 consecutive, nonduplicate clinical isolates of aerobically growing gram-negative bacilli from patients at 42 intensive care unit (ICU) and 21 non-ICU sites across the United States were tested on-site for antibiotic susceptibility. From these isolates, 746 screen-positive isolates (11.6{\%}) were referred to a research facility and investigated to determine the prevalence of ESBLs in all gram-negative isolates, transferable AmpC β-lactamases in Klebsiella pneumoniae, and carbapenemases in Enterobacteriaceae. The investigations involved phenotypic tests, isoelectric focusing, β-lactamase inhibitor studies, spectrophotometric assays, induction assays, and molecular analyses. ESBLs were detected only in Enterobacteriaceae (4.9{\%} of all Enterobacteriaceae) and were found in species other than those currently recommended for ESBL testing by the CLSI (formerly NCCLS). These isolates occurred at 74{\%} of the ICU sites and 43{\%} of the non-ICU sites. Transferable AmpC β-lactamases were detected in 3.3{\%} of K. pneumoniae isolates and at 16 of the 63 sites (25{\%}) with no difference between ICU and non-ICU sites. Three sites submitted isolates that produced class A carbapenemases. No class B or D carbapenemases were detected. In conclusion, organisms producing ESBLs and transferable AmpC β-lactamases were widespread. Clinical laboratories must be able to detect important β-lactamases to ensure optimal patient care and infection control.",
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