| ESBL AMPC Detection Cross |
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| PRODUCTS - BETA LACTAMASE, ESBL & AMPC DETECTION | |||||||||||
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Clinical failure of Cephalosporin and Monobactam therapy due to Extended Spectrum β-lactamases (ESBLs) is a growing problem in hospitals as they undetected by current isolation and susceptibility tests. ESBLs often have low, or only marginally elevated minimum inhibitory concentrations (MICs) to third generation cephalosporins and monobactams which means that they appear sensitive in routine susceptibility testing. Over the last 10 years, ESBL producing Enterobacteriaceae have dramatically increased such that in some studies, as many as 40% of Klebsiella spp isolated in ICU have been shown to produce ESBL. The ESBL detection disc shows the presence of ESBLs and can be easily incorporated into routine screening methods. The Cross includes a β-lactamase inhibitor, Clavulinic acid, next to the two third generation Cephalosporins that have been most widely recommended for ESBL demonstration ; Ceftazidime and Cefotaxime. The Clavulinic acid suppresses the production of ESBL and therefore the organism can be inhibited by the cephalosporin where they diffuse together in the medium. The tips of the cross are optimally positioned to produce easy to read, reproducible results. Other ESBL detection protocols involve positioning individual discs or strips at carefully measured distances. The ESBL cross can be easily applied to the plate with minimal delay. This design conforms to the specification for the double disc Confirmatory Test of the National Standards Method QSOP 51i2.2 published by the Health Protection Agency.
The presence of ESBL is shown as an extended zone of inhibition towards the Augmentin tip or a discrete zone of inhibition between the discs adjacent to the Augmentin tip.
A truncated zone of inhibition towards the Imipenam tip shows the presence of Amp-C lactamase.
Technical Information
References: LABORATORY DETECTION AND REPORTING OF BACTERIA WITH EXTENDED SPECTRUM ß-LACTAMASES Issue no:2.2, Standards Unit, Evaluations ans Standards Laboratory (2008). Ref QSOP 51i2.2 Jarlier V, Nicolas M-H, Fournier G, Philippon A; Extended spectrum β-lactam agents in Enterobacteriaceae; Reviews of Infectious Diseases; 1998; Vol.10, No.4 p867-877. Gove E, Marcus L; An alternative method for confirming the presence of AMP-C and ESBLs from clinical isolates; Poster at ASM. Jacoby GA, Han P; Detection of ESBLs in clinical isolates of K pneumoniae and E coli; Journal of Clinical Microbiology; 1996; Vol.34; No.4 p908-911. MacKenzie FM, Gould IM; Extended spectrum β-lactamases; Journal of Infection; 1998; 36. p255-258.
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