Publication: Molecular characterization of extended-spectrum beta-lactamases and its correlation with clinical laboratory standards institute interpretive criteria for disk diffusion susceptibility testing in Enterobacteriaceae isolates in Thailand
Issued Date
2012-11-01
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ISSN
01251562
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2-s2.0-84873045931
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Mahidol University
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SCOPUS
Bibliographic Citation
Southeast Asian Journal of Tropical Medicine and Public Health. Vol.43, No.6 (2012), 1461-1469
Suggested Citation
Teerawit Tangkoskul, Surapee Tiengrim, Supiluck Onsomang, Naratchaphan Pati, Nalinee Aswapokee, Visanu Thamlikitkul, Methee Chayakulkeeree Molecular characterization of extended-spectrum beta-lactamases and its correlation with clinical laboratory standards institute interpretive criteria for disk diffusion susceptibility testing in Enterobacteriaceae isolates in Thailand. Southeast Asian Journal of Tropical Medicine and Public Health. Vol.43, No.6 (2012), 1461-1469. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/14553
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Title
Molecular characterization of extended-spectrum beta-lactamases and its correlation with clinical laboratory standards institute interpretive criteria for disk diffusion susceptibility testing in Enterobacteriaceae isolates in Thailand
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Abstract
We performed extended-spectrum p-lactamase (ESBL) phenotypic testing and molecular characterization of three ESBL genes (TEM, SHV and CTX-M) and susceptibility testing by Clinical Laboratory Standards Institute (CLSI) disk diffusion method against three cephalosporins (ceftriaxone, ceftazidime, cefepime) and a cephamycin (cefoxitin) among 128 Thai Escherichia coli and 84 Thai Klebsiella pneumoniae clinical isolates. ESBL production was discovered in 62% of E. coli and 43% of K. pneumoniae isolates. All isolates susceptible to ceftriaxone were ESBL-negative. Nearly all isolates non-susceptible to ceftriaxone, ceftazidime and cefepime produced ESBL; the presence of CTX-M genes in the isolates correlated with a ceftriaxone non-susceptible phenotype. Thirty-nine of 83 isolates (47%) of ceftazidime-susceptible E. coli and 50 of 99 isolates (50.5%) of cefepime-susceptible E.coli were ESBL-producing. SHV-type B-lactamase genes were more prevalent among K. pneumoniae than £. coli isolates. CTX-M was the major ESBL gene harbored by ESBL-producers in both E. coli and K. pneumoniae isolates. Non-CTX-M ESBL-producers were found only among K. pneumoniae isolates. This study reveals an increase in ESBL-producing Enterobacteriaceae among Thai isolates and demonstrates gaps in the current CLSI disk diffusion susceptibility guidelines; it indicates the results of ceftazidime and cefepime disk diffusion susceptibility testing using CLSI criteria should be interpreted with caution.