Prevalence, microbiology, and clinical characteristics of extended-spectrum β-lactamase-producing Enterobacter spp., Serratia marcescens, Citrobacter freundii, and Morganella morganii in Korea

  • S.-H. Choi
  • J. E. Lee
  • S. J. Park
  • M.-N. Kim
  • E. J. Choo
  • Y. G. Kwak
  • J.-Y. Jeong
  • J. H. Woo
  • N. J. Kim
  • Y. S. Kim
Article

Abstract

We examined the prevalence and characteristics of extended-spectrum β-lactamase (ESBL)-producing clinical isolates among Enterobacter spp., Serratia marcescens, Citrobacter freundii, and Morganella morganii, and evaluated screening criteria, clinical characteristics and outcomes of infections caused by ESBL-producing organisms. Between January and June 2005, a total of 493 nonduplicate consecutive isolates were collected at Asan Medical Center, a 2,300-bed tertiary hospital in Seoul, Republic of Korea. Fifty isolates (10.1%) were positive for phenotypical ESBL-test. The positive rate of phenotypical ESBL-test in Enterobacter spp., S. marcescens, C. freundii, and M. morgannii was 12.8%, 12.4%, 4.9%, and 0% respectively. SHV-12 (18 isolates), CTX-M-9 (17 isolates), and TEM-52 (five isolates) were the most prevalent ESBL types. The ESBL in 17 strains could not be identified. As an ESBL screening criterion, the cefepime MIC ≥1 μg/ml had the highest sensitivity (0.84) and specificity (0.87). Half of the ESBL-producing isolates (25/50) were judged as pathogens. Cholangitis (ten cases), and pneumonia (six cases) were the most common infections. The overall mortality was 12.0%.

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • S.-H. Choi
    • 1
    • 2
  • J. E. Lee
    • 1
    • 2
  • S. J. Park
    • 1
    • 2
  • M.-N. Kim
    • 1
    • 2
    • 3
  • E. J. Choo
    • 1
    • 2
    • 4
  • Y. G. Kwak
    • 1
    • 2
    • 5
  • J.-Y. Jeong
    • 1
    • 2
  • J. H. Woo
    • 1
    • 2
  • N. J. Kim
    • 1
    • 2
  • Y. S. Kim
    • 1
    • 2
  1. 1.Division of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
  2. 2.Center for Antimicrobial Resistance and Microbial GeneticsUniversity of UlsanSeoulSouth Korea
  3. 3.Department of Laboratory Medicine, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
  4. 4.Division of Infectious DiseasesSoonchunhyang University HospitalBucheonSouth Korea
  5. 5.Department of Internal Medicine, Ilsanpaik HospitalInje UniversityGoyangSouth Korea

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