A rapid and simple method to detect ESBL in enterobacter cloacae based on MIC of cefepime

Abstract

Introduction: The aim of this study was to identify a rapid and simple phenotypic method for extended-spectrum β-lactamase (ESBL) detection in Enterobacter cloacae. Methods: A total of 79 consecutive, non-repeated samples of E. cloacae were evaluated. Four phenotypic methods were applied for ESBL detection, results were compared to multiplex polymerase chain reaction (PCR) as the gold standard reference method: 1) ceftazidime and cefotaxime disks with and without clavulanate, both with boronic acid added; 2) disk approximation using cefepime and amoxicillin/clavulanate; 3) ESBL screening by minimum inhibitory concentration (MIC) ≥ 16μg/mL and 4) by MIC ≥ 2μg/mL for cefepime. Results: Method 4 showed the best combination of sensitivity (100%) and specificity (94%). Conclusions: MIC ≥ 2μg/mL for cefepime would be very useful for the phenotypic detection of ESBL in samples of E. cloacae.