Prevalence of Extended-Spectrum β-Lactamase-Producing Enterobacter cloacae in the Asia-Pacific Region: Results from the SENTRY Antimicrobial Surveillance Program, 1998 to 2001

Abstract

Enterobacter cloacae strains from hospitalized patients with a range of infections were collected by 17 laboratories in the Asia-Pacific region and South Africa. Isolates for which ceftriaxone MICs were above 1μ g/ml and/or ceftazidime MICs were above 2 μg/ml, as well as 46 strains for which ceftriaxone and/or ceftazidime MICs were at or below these values, were screened for levels of extended-spectrumβ -lactamase (ESBL) production through the use of broth microdilution for the detection of clavulanate enhancement of the activity of ceftriaxone, ceftazidime, and cefepime. Of the isolates examined, ceftriaxone and/or ceftazidime had elevated MICs for 44%, of which 36% were ESBL positive. ESBL-positive strains were commonly susceptible to piperacillin-tazobactam and more frequently resistant to several other antimicrobials studied. A cefepime MIC above 0.25 μg/ml had the highest sensitivity (100%) and specificity (74%) for predicting the presence of an ESBL.