Narrow-spectrum cephalosporin susceptibility testing of Escherichia coli with the BD phoenix automated system: Questionable utility of cephalothin as a predictor of cephalexin susceptibility

Sean Xiang Zhang, Fern Parisian, Yvonne Yau, Jeffrey D. Fuller, Susan M. Poutanen, Susan E. Richardson

Research output: Contribution to journalArticle

Abstract

The resistance of Escherichia coli to cephalothin was found to be overestimated when the Phoenix automated susceptibility system was used to determine resistance compared to reference broth microdilution, a finding that jeopardized the use of cephalexin for first-line treatment of urinary tract infections in children. In addition, using broth microdilution, we studied the accuracy of either cephalothin or cefazolin in predicting cephalexin susceptibility. In contrast to the recommendation of the Clinical Laboratory Standards Institute (CLSI), we found that cephalothin is not a reliable predictor of cephalexin susceptibility. Cefazolin performs no better in this role. We suggest that laboratories should consider testing and reporting cefazolin and cephalexin independently, according to clinical need.

Original languageEnglish (US)
Pages (from-to)3762-3763
Number of pages2
JournalJournal of Clinical Microbiology
Volume45
Issue number11
DOIs
StatePublished - Nov 2007
Externally publishedYes

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Cephalexin
Cephalothin
Cephalosporins
Cefazolin
Escherichia coli
Urinary Tract Infections

ASJC Scopus subject areas

  • Microbiology (medical)
  • Microbiology

Cite this

Narrow-spectrum cephalosporin susceptibility testing of Escherichia coli with the BD phoenix automated system : Questionable utility of cephalothin as a predictor of cephalexin susceptibility. / Zhang, Sean Xiang; Parisian, Fern; Yau, Yvonne; Fuller, Jeffrey D.; Poutanen, Susan M.; Richardson, Susan E.

In: Journal of Clinical Microbiology, Vol. 45, No. 11, 11.2007, p. 3762-3763.

Research output: Contribution to journalArticle

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abstract = "The resistance of Escherichia coli to cephalothin was found to be overestimated when the Phoenix automated susceptibility system was used to determine resistance compared to reference broth microdilution, a finding that jeopardized the use of cephalexin for first-line treatment of urinary tract infections in children. In addition, using broth microdilution, we studied the accuracy of either cephalothin or cefazolin in predicting cephalexin susceptibility. In contrast to the recommendation of the Clinical Laboratory Standards Institute (CLSI), we found that cephalothin is not a reliable predictor of cephalexin susceptibility. Cefazolin performs no better in this role. We suggest that laboratories should consider testing and reporting cefazolin and cephalexin independently, according to clinical need.",
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