M131-1

Cystoscopic urine: >100 x 10^6 cfu/L Escherichia coli (ESBL positive) – Shipped May 2013

HISTORY

A sample simulating a cystoscopy urine obtained from a 30 year old female out-patient, was sent to category A, B, and C laboratories.

Participants were expected to isolate, report colony count, and identify Escherichia coli as well as report antibiotic susceptibilities.

As this isolate produced an extended spectrum β-lactamase (ESBL), it was also expected laboratories would notify infection control.

MAIN EDUCATIONAL POINTS from M131-1

  1. ESBL-producing Enterobacteriaceae are becoming more prevalent throughout the world.
  2. Controversy persists with lower cephalosporin breakpoints in new CLSI and EUCAST guidelines and whether it is necessary to edit susceptibility categories if an ESBL is found.

Full critique (PDF)

Posted in Clinical Bacteriology Results, critiques