Microbiological and clinical changes following the transition to the 2010 revised CLSI breakpoints for extended-spectrum cephalosporin in Enterobacterales

Ben Vaknin, Nancy Bishouty, Amos Adler*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

In 2016, our laboratory adopted the 2010 CLSI extended-spectrum cephalosporins (ESC) breakpoint criteria in Enterobacterales. ESBL testing had continued in Blood cultures but discontinued in General Cultures. The aims of this study were to examine the effect of this transition on (1) the resistance rates to ESC; (2) the consumption of parenteral β-lactam antimicrobials, and (3) the therapeutic use of ESC and the outcome of patients infected by ESBL-producing Enterobacterales. In K. pneumoniae and E. coli, the ESC resistance rates had increased, declined or remained unchanged in Urine, General and Blood cultures, respectively. In P. mirabilis, the resistance rates declined for ceftazidime but remained unchanged for ceftriaxone. Carbapenem consumption had not replaced ESC, but the consumption of piperacillin-tazobactam had increased. The use of ESC in suspected ESBL infections had increased slightly, without effect on clinical outcome.

Original languageEnglish
Article number115654
JournalDiagnostic Microbiology and Infectious Disease
Volume103
Issue number1
DOIs
StatePublished - May 2022

Keywords

  • CLSI
  • ESBL
  • breakpoint
  • cephalosporin

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