TY - BOOK AU - Majumdar, Anjali TI - Impact of CLSI and EUCAST Cefepime breakpoint changes on the susceptibility reporting for Enterobacteriaceae SN - 0732-8893 PY - 2017/// KW - *Anti-Bacterial Agents/pd [Pharmacology] KW - *Bacterial Proteins/ge [Genetics] KW - *Cephalosporins/pd [Pharmacology] KW - *Enterobacteriaceae/ge [Genetics] KW - beta-Lactamases/ge [Genetics] KW - Ceftriaxone/pd [Pharmacology] KW - Drug Resistance, Multiple, Bacterial KW - Enterobacteriaceae Infections/di [Diagnosis] KW - Enterobacteriaceae Infections/dt [Drug Therapy] KW - Enterobacteriaceae/de [Drug Effects] KW - Escherichia coli/de [Drug Effects] KW - Humans KW - Klebsiella/de [Drug Effects] KW - Microbial Sensitivity Tests KW - Retrospective Studies KW - MedStar Washington Hospital Center KW - Medicine/Infectious Diseases KW - Journal Article N2 - CONCLUSIONS: Lower cefepime MIC breakpoints decrease cefepime susceptibility for isolates harboring ESBLs, while sparing the majority of those with AmpCs; Copyright Published by Elsevier Inc; METHODS: Using Enterobacteriaceae susceptibility data from 2013 comparisons of MIC breakpoints were performed using Pearson's chi-squared test. Molecular testing on a subset of isolates was done; OBJECTIVE: We analyzed the effects of different cefepime MIC breakpoints on Enterobacteriaceae cefepime susceptibility and the presence of AmpC and extended-spectrum beta-lactamase (ESBL) genes within the cefepime MIC interpretative categories; RESULTS: Among 3784 non-duplicate clinical isolates, cefepime susceptibility decreased from 97.6% to 96.1% to 93.7% for CLSI 2013, CLSI 2014, and EUCAST 2011, respectively. In ceftriaxone non-susceptible isolates, cefepime susceptibility decreased from 79% to 66% (P<0.0001) using CLSI 2013 and 2014, respectively, which was greater and statistically significant for Escherichia coli and Klebsiella spp. but not for Enterobacter spp. (P=0.06). Isolates with MIC <=1mug/mL more often harbored AmpC (77%) than ESBL (18%) genes UR - https://dx.doi.org/10.1016/j.diagmicrobio.2017.08.020 ER -