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Ko, Chung, Song, Yoon, Sung, and Kim: Evaluation of the MicroScan NegCombo Panel Type 44 for Detection of Extended-Spectrum β-Lactamase among Clinical Isolates of Escherichia coli, Klebsiella species, and Proteus mirabilis
Original Article

Korean J Leg Med 2009;29(1):35-40.

Published online: 14 February 2009

DOI: https://doi.org/10.3343/kjlm.2009.29.1.35

Evaluation of the MicroScan NegCombo Panel Type 44 for Detection of Extended-Spectrum β-Lactamase among Clinical Isolates of Escherichia coli, Klebsiella species, and Proteus mirabilis

Sun-Young Ko, M.D., Jae-Woo Chung, M.D., Ah Jin Song, M.T., Nam-Surp Yoon, M.T., Heungsup Sung, M.D., Mi-Na Kim, M.D.

Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea

Corresponding author: Heungsup Sung, M.D. Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, 388-1 Pungnap-2dong, Songpa-gu, Seoul 138-736, Korea Tel: +82-2-3010-4499, Fax: +82-2-478-0884 E-mail: sung@amc.seoul.kr

Received 17 August 20084 October 2008       Accepted 4 October 2008

Copyright © 2009 by the Korean Society for Legal Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Accurate and rapid detection of extended-spectrum β-lactamases (ESBLs) is important in guiding proper antimicrobial therapy for infected patients. We evaluated the performance of MicroScan NegCombo Type 44 panel (Dade Behring, USA), which was developed to confirm ESBL-producing Enterobacteriaceae using ceftazidime/clavulanate and cefotaxime/clavulanate.

Methods

From August 30 to September 20, 2007, 206 non-duplicate clinical isolates, including 106 Escherichia coli, 81 Klebsiella pneumoniae, 11 Klebsiella oxytoca, and 8 Proteus mirabilis were subcultured and tested with Type 32 and Type 44 panels. The results were compared with those of the CLSI phenotypic confirmatory test (CLSI-PCT) and disk approximation test (DAT). Isolates not susceptible to cefotetan or flagged as “Possible ESBL, unable to interpret confirm test (Possible ESBL)” on Type 44 panel were tested with boronic acid disks to confirm AmpC β-lactamases (AmpC) production.

Results

Of the 206 isolates tested, 44 (21.4%) produced ESBL by CLSI-PCT or DAT, including 27 E. coli, 14 K. pneumoniae, 2 K. oxytoca, and 1 P. mirabilis. Thirty-eight isolates flagged as “Confirmed ESBL” on Type 44 panel were all confirmed as ESBL-producers. Of 14 K. pneumoniae flagged as “Possible ESBL”, 6 were confirmed as ESBL and AmpC co-producers and 8 as AmpC-producers.

Conclusions

Type 44 panel showed an excellent performance in detecting ESBL-producing E. coli, Klebsiella spp., and P. mirabilis. When flagged as “Confirmed ESBL”, no other confirmatory test was necessary to report as ESBL; however, “Possible ESBL” required a differential test for AmpC production.

Keywords: Extended-spectrum β-lactamases, NegCombo Type 44, plasmid-mediated AmpC β-lactamases

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Table 1.
Extended-spectrum β-lactamase (ESBL) interpretative results of MicroScan NegCombo Panel Type 44 and NegCombo Panel Type 32
  N isolates Total
ESBL only ESBL+ AmpC AmpC only Non-ESBL, non-AmpC
NegCombo Panel Type 44 interpretation          
 Confirmed ESBL 38 0 0 0 38
 Possible ESBL∗ 0 6 8 0 14
 Non-ESBL 0 0 0 154 154
NegCombo Panel Type 32 interpretation          
 Suscpected ESBL 37 1 0 3 41
 Suspected ESBL+ possible AmpC† 1 5 8 2 16
 Non-ESBL 0 0 0 149 149

∗ Possible ESBL, unable to interpret confirm test;

† Suspected ESBL possible hyperproduction of AmpC.

Abbreviation: AmpC, AmpC β-lactamase.

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