{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:50:27Z","timestamp":1790707827669,"version":"4.1.0"},"reference-count":34,"publisher":"American Society for Microbiology","issue":"9","license":[{"start":{"date-parts":[[2011,9,1]],"date-time":"2011-09-01T00:00:00Z","timestamp":1314835200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2011,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            In 2010 the Clinical and Laboratory Standards Institute (CLSI) lowered the susceptibility breakpoints of some cephalosporins and aztreonam for\n            <jats:named-content content-type=\"genus-species\">Enterobacteriaceae<\/jats:named-content>\n            and eliminated the need to perform screening for extended-spectrum \u03b2-lactamases (ESBLs) and confirmatory tests. The aim of this study was to determine how many ESBL-producing strains of three common species of\n            <jats:named-content content-type=\"genus-species\">Enterobacteriaceae<\/jats:named-content>\n            test susceptible using the new breakpoints. As determined with the CLSI screening and confirmatory tests, 382 consecutive ESBL-producing strains were collected at Huashan Hospital between 2007 and 2008, including 158 strains of\n            <jats:named-content content-type=\"genus-species\">Escherichia coli<\/jats:named-content>\n            , 164 of\n            <jats:named-content content-type=\"genus-species\">Klebsiella pneumoniae<\/jats:named-content>\n            , and 60 of\n            <jats:named-content content-type=\"genus-species\">Proteus mirabilis<\/jats:named-content>\n            . Susceptibility was determined by the CLSI agar dilution method. CTX-M-, TEM-, and SHV-specific genes were determined by PCR amplification and sequencing.\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>CTX-M<\/jats:sub>\n            genes alone or in combination with\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>SHV<\/jats:sub>\n            were present in 92.7% (354\/382) of these ESBL-producing strains. Forty-two (25.6%) strains of\n            <jats:named-content content-type=\"genus-species\">K. pneumoniae<\/jats:named-content>\n            harbored SHV-type ESBLs alone or in combination. No TEM ESBLs were found. Utilizing the new breakpoints, all 382 strains were resistant to cefazolin, cefotaxime, and ceftriaxone, while 85.0 to 96.7% of\n            <jats:named-content content-type=\"genus-species\">P. mirabilis<\/jats:named-content>\n            strains tested susceptible to ceftazidime, cefepime, and aztreonam, 41.8 to 45.6% of\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            strains appeared to be susceptible to ceftazidime and cefepime, and 20.1% of\n            <jats:named-content content-type=\"genus-species\">K. pneumoniae<\/jats:named-content>\n            were susceptible to cefepime. In conclusion, all ESBL-producing strains of\n            <jats:named-content content-type=\"genus-species\">Enterobacteriaceae<\/jats:named-content>\n            would be reported to be resistant to cefazolin, cefotaxime, and ceftriaxone by using the new CLSI breakpoints, but a substantial number of ESBL-containing\n            <jats:named-content content-type=\"genus-species\">P. mirabilis<\/jats:named-content>\n            and\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            strains would be reported to be susceptible to ceftazidime, cefepime, and aztreonam, which is likely due to the high prevalence of CTX-M type ESBLs.\n          <\/jats:p>","DOI":"10.1128\/jcm.00222-11","type":"journal-article","created":{"date-parts":[[2011,7,14]],"date-time":"2011-07-14T02:57:40Z","timestamp":1310612260000},"page":"3127-3131","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":49,"title":["Susceptibility of Extended-Spectrum-\u03b2-Lactamase-Producing Enterobacteriaceae According to the New CLSI Breakpoints"],"prefix":"10.1128","volume":"49","author":[{"given":"Peng","family":"Wang","sequence":"first","affiliation":[{"name":"Institute of Antibiotics, Huashan Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fupin","family":"Hu","sequence":"additional","affiliation":[{"name":"Institute of Antibiotics, Huashan Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zizhong","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, the First Affiliated Hospital, Anhui Medical University, Hefei 230022, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Ye","sequence":"additional","affiliation":[{"name":"Institute of Antibiotics, Huashan Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demei","family":"Zhu","sequence":"additional","affiliation":[{"name":"Institute of Antibiotics, Huashan Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun F.","family":"Wang","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, Georgia 30303"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minggui","family":"Wang","sequence":"additional","affiliation":[{"name":"Institute of Antibiotics, Huashan Hospital"},{"name":"Institute of Biomedical Science, Fudan University, Shanghai 200040, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.42.7.1636"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.44.8.2230-2230.2000"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.1.1-14.2004"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2007.01850.x"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2006.06.015"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/32.2.247"},{"key":"e_1_3_2_8_2","volume-title":"M07-A8","author":"Clinical and Laboratory Standards Institute","year":"2009","unstructured":"Clinical and Laboratory Standards Institute. 2009. 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