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The page below is a sample from the LabCE course Case Studies in Clinical Microbiology. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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ESBL Screening by Broth Microdilution

  • For screening of K. pneumonia, K. oxytoca, and E. coli isolates by broth microdilution, the use of cefpodoxime (4 µg/mL), ceftazidime (1 µg/mL), aztreonam (1 µg/mL), cefotaxime (1 µg/mL), or ceftriaxone (1 µg/mL) is proposed. For P. mirabilis isolates, the use of cefpodoxime (1 µg/mL), ceftazidime (1 µg/mL), or cefotaxime (1 µg/mL) is proposed. Again, for screening purposes in all of these organisms, the use of more than one of these agents improves the sensitivity of detection.
  • For K. pneumonia, K. oxytoca, and E. coli, MIC growth ≥ 2 µg/mL ceftazidime, aztreonam, cefotaxime, or ceftriaxone or MIC ≥ 8 µg/mL for cefpodoxime may indicate ESBL production and phenotypic confirmation should be performed. For P. mirabilis, an MIC ≥ 2 µg/mL for cefpodoxime, ceftazidime, or cefotaxime may indicate ESBL production and phenotypic confirmation should be performed.