{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T14:20:44Z","timestamp":1782915644683,"version":"3.54.5"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T00:00:00Z","timestamp":1678060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The spread of multi-resistant bacteria endangers the effectiveness of empirical antimicrobial treatment, particularly in Gram-negative bloodstream infections. Thus, rapid and reliable susceptibility testing has become a key challenge of modern microbiology. Here, we evaluated a combination disc test for rapid detection of ESBL production in Escherichia coli (rapid combination disc test, RCDT) directly from blood cultures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>RCDT with discs containing cefotaxime and ceftazidime alone or in combination with clavulanic acid was validated using a cryo-collection of 96 third-generation cephalosporin-resistant (3GCR), whole-genome sequenced E. coli isolates spiked into blood culture bottles. All isolates were subjected to RCDT and rapid antibiotic susceptibility testing (RAST). Zone diameters were assessed after 4, 6 and 8 h of incubation. All isolates also underwent conventional combination disc testing. The real-life performance of RCDT was assessed by analysis of 306 blood cultures growing E. coli.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty of 90 (88.9%) ESBL-positive E. coli validation isolates were correctly identified by RCDT after 4 h of incubation. The detection rate increased to 100% after 6 and 8 h. RCDT was negative in six 3GCR E. coli isolates expressing class B or C \u03b2-lactamases. RCDT from routine blood cultures correctly classified all 56 ESBL producers and 245\/250 ESBL-negative isolates after 4 h, resulting in 100% sensitivity and 98.8% specificity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>RCDT is a reliable method for rapid ESBL detection in E. coli directly from positive blood cultures. RCDT might complement RAST to support antibiotic stewardship interventions and treatment decisions.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jac\/dkad041","type":"journal-article","created":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T13:40:25Z","timestamp":1678196425000},"page":"1028-1033","source":"Crossref","is-referenced-by-count":2,"title":["Evaluation of a rapid combination disc test (RCDT) for direct phenotypic detection of extended-spectrum \u03b2-lactamase production in<i>E. coli<\/i>from positive blood culture bottles"],"prefix":"10.1093","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2749-1201","authenticated-orcid":false,"given":"Benjamin","family":"Berinson","sequence":"first","affiliation":[{"name":"Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf , Martinistrasse 52, D-20246 Hamburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Degel-Brossmann","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf , Martinistrasse 52, D-20246 Hamburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flaminia","family":"Olearo","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf , Martinistrasse 52, D-20246 Hamburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannes G","family":"Roggenkamp","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf , Martinistrasse 52, D-20246 Hamburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Both","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf , Martinistrasse 52, D-20246 Hamburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Aepfelbacher","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf , Martinistrasse 52, D-20246 Hamburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Christner","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf , Martinistrasse 52, D-20246 Hamburg , 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