Modified double-disc test for detection of extended-spectrum beta-lactamases in Escherichia coli and Klebsiella pneumoniae.

This study evaluates the performance of a modified double-disc test (MDDT) for the detection of extended-spectrum beta-lactamases (ESBLs) in clinical isolates of Escherichia coli and Klebsiella pneumoniae. Ninety-six isolates of E. coli and 40 K. pneumoniae are studied for ESBL production by the National Committee for Clinical Laboratory Standards (NCCLS) combination disc tests and MDDT A total of 112 (82%) isolates (80 [83%] E. coli, 32 [80%] K. pneumoniae) were positive for ESBL by MDDT compared to 102 (75%; 72 [75%] E. coli and 30 [75%] K. pneumoniae) by the NCCLS method. In 10 (7.4%) isolates, ESBLs were detected only by MDDT Twenty-four (17.6%) isolates were negative for ESBL by both methods. The protocol described in this study provides a more sensitive approach than does the NCCLS method for ESBL detection in E. coli and K. pneumoniae.