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When a panel on our Microscan flags a sensitivity as a possible ESBL, we do confirmatory tests. If the result is negative for ESBL, should we be confirming for Amp C??
any help would be appreciated. thanks
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Currently, there is no standardized test for detecting the presence of AmpC beta-lactamase in isolates of E. coli, Klebsiella spp., and Proteus mirabilis which are negative for ESBL confirmatory testing.
One clue to the presence of AmpC is to examine the cephamycin result (e.g. cefotetan or cefoxitin). Cephamycin resistant isolates may be producing an AmpC enzyme, either alone or in combination with an ESBL (see MicroScan Technical Support Bulletin 158, April 2007).
The AmpC disk test has been described, see Black et al. Jour Clin Microbiol 43:3110-3113, 2005. It is not available commercially yet.
Another method has been described using boronic acid as an inhibitor, see Yagi et al. Jour Clin Microbiol 43_2351-2358, 2005.
We hope that we were able to answer your question.
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