Detection and Occurrence of Extended-Spectrum beta-Lactamase-Producing Citrobacter freundii, Enterobacter spp., Proteus spp., and Serratia marcescens Isolates / 임상검사와정도관리

ABSTRACT

BACKGROUND: The occurrence of extended-spectrum beta-lactamases (ESBLs) in enterobacteria that possess inducible Bush group 1 chromosomal beta-lactamases is being increasingly reported worldwide. The current National Committee for Clinical Laboratory Standards documents do not indicate the tests that should be used for the detection of ESBLs in Enterobacteriaceae except Klebsiella spp. and Escherichia coli. We determined the occurrence and detection of ESBL-producing Enterobacteriaceae isolates. METHODS: One hundred fifty-six consecutive, non-repeated isolates of Citrobacter freundii, Enterobacter spp., Proteus spp., and Serratia marcescens were collected. These isolates were performed broth microdilution antimicrobial susceptibility test, Vitek ESBL detection test, and double disk synergy (DDS) test. All the DDS-positive strains were tested PCR amplification of the blaTEM and blaSHV alleles. RESULTS: S. marcescens (27.3%) was the most frequently isolated ESBL producers followed by E. cloacae (23.8%), E. aerogenes (18.2%), C. freundii (13.3%), and P. mirabilis (8.3%). Among the total of 30 isolates that were considered ESBL producers, the Vitek ESBL detection test was positive for 26 (86.7%) strains. The genotypes of ESBLs were predominently SHV type (10 isolates) followed by others (8 isolates), SHV and TEM (7 isolates), and TEM type (5 isolates). CONCLUSIONS: Our findings indicate that 19.2% of all Enterobacteriaceae except E. coli and Klebsiella spp. tested produced ESBLs. The Vitek ESBL detection test seems to be a useful test to identify ESBL-producing strains of C. freundii, Enterobacter spp., Proteus spp., and S. marcescens isolates.