| Author/Editor | Mueller-Premru, Manica; Križan-Hergouth, Veronika; Gubina, Marija | |
| Title | Naše izkušnje z beta-laktamazami razširjenega spektra | |
| Type | članek | |
| Source | In: Dragaš AZ, Lorenčič-Robnik S, Kotnik-Kevorkijan B, editors. Zbornik predavanj Bolnišnične okužbe; 1999 maj 21-22; Maribor. Maribor: Splošna bolnišnica Maribor, | |
| Publication year | 1999 | |
| Volume | str. 199-206 | |
| Language | slo | |
| Abstract | Extended-spectrum beta-lactamases (ESBL's), which hydrolyze the 1st, 2nd and the 3rd generation of cephalosporins and monobactams are plasmidcoded enzymes found in enterobacteria and classified according to Bush as class 2b' enzymes. Presumptive ESBL producers are isolates of Klebsiella sp. and Escherichia coli with smaller inhibition zones for 3rd generation cephalosporins and monobactams than usual, which are increased 5 mm or more by the addition of clavulanic acid. ESBL's are detected with the double disk sinergy test or simply by adding clavulanic acid to the disks and with the ESBL E-test. Positive result is the increase of the inhibition zone at the surface between amoxicillin/clavulanic acid and one or more of the other disks or among those disks with clavulanic acid and those without it. In E-test positive result is the ratio 4 or higher between antibiotic and antibiotic/clavulanic acid combination. In our laboratories zone inhibition measuring and double disk sinergy test are used for screening and E-test ESBL as the confirmation test. Resistance and intermediate susceptibility to cefotaxime, which reflect ESBL and other mechanisms of resistance, were in 1998 for Klebsiella sp. from 15,4 % to 58,9 % in different clinical materials and for Escherichia coli from 1,2 % to 6,5 %. ESBL positive bacteria were isolated from sputa, wounds, blood cultures, tracheal aspirates and urine of intensive care unit patients receiving broad spectrum antibiotics and were often multiresistant. | |
| Descriptors | BETA-LACTAM RESISTANCE CEPHALOSPORINASE KLEBSIELLA ESCHERICHIA COLI MICROBIAL SENSITIVITY TESTS BETA-LACTAMASES CEPHALOSPORINS CLAVULANIC ACIDS AMOXICILLIN |