Laboratory proficiency in susceptibility testing of Helicobacter pylori using agar dilution and E test methods

2001 ◽  
Vol 120 (5) ◽  
pp. A586-A587
Author(s):  
L BEST ◽  
S JO ◽  
V VANZANTEN ◽  
D HALDANE ◽  
V LOO ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Susceptibility Testing ◽  
Test Methods ◽  
Agar Dilution

Laboratory proficiency in susceptibility testing of Helicobacter pylori using agar dilution and E test methods

2001 ◽  
Vol 120 (5) ◽  
pp. A586-A587
Author(s):  
Linda M. Best ◽  
Sander Jo ◽  
Veldhuyzen van Zanten ◽  
David J.M. Haldane ◽  
Vivian Loo ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Susceptibility Testing ◽  
Test Methods ◽  
Agar Dilution

scholarly journals Multilaboratory Comparison of Proficiencies in Susceptibility Testing of Helicobacter pylori and Correlation between Agar Dilution and E Test Methods

2003 ◽  
Vol 47 (10) ◽  
pp. 3138-3144 ◽  
Author(s):  
L. M. Best ◽  
D. J. M. Haldane ◽  
M. Keelan ◽  
D. E. Taylor ◽  
A. B. R. Thomson ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Susceptibility Testing ◽  
Clinical Laboratory ◽  
Reference Method ◽  
Test Methods ◽  
Culture Collection ◽  
Test Method ◽  
National Committee ◽  
Reference Laboratory ◽  
Agar Dilution

ABSTRACT Susceptibility testing was performed at seven Canadian microbiology laboratories and the Helicobacter Reference Laboratory, Halifax, Nova Scotia, Canada, to assess susceptibility testing proficiency and the reproducibility of the results for clarithromycin and metronidazole and to compare the Epsilometer test (E test) method to the agar dilution reference method. Control strain Helicobacter pylori ATCC 43504 (American Type Culture Collection) and 13 clinical isolates (plus duplicates of four of these strains including ATCC 43504) were tested blindly. The National Committee for Clinical Laboratory Standards (NCCLS) guidelines for agar dilution testing were followed, and the same suspension of organisms was used for agar dilution and E test. Antimicrobials and E test strips were provided to the investigators. Methods were provided on a website (www.Helicobactercanada.org ). Each center reported MICs within the stated range for strain ATCC 43504. Compared to the average MICs, interlaboratory agreements within 2 log2 dilutions were 90% (range, 69 to 100%) for clarithromycin by agar dilution, with seven very major errors [VMEs], and 85% (range, 65 to 100%) by E test, with three VMEs. Interlaboratory agreements within 2 log2 dilutions were 83% (range, 50 to 100%) for metronidazole by agar dilution, with six VMEs and eight major errors (MEs), and 75% (range, 50 to 94%) by E test, with four VMEs and four MEs. At lower and higher concentrations of antibiotic, E test MICs were slightly different from agar dilution MICs, but these differences did not result in errors. When a standardized protocol based on NCCLS guidelines was used, most participants in this study correctly identified clarithromycin- and metronidazole-susceptible and -resistant strains of H. pylori 93% of the time by either the agar dilution or E test method, and the numbers of errors were relatively equivalent by both methods.

E-Test or Agar Dilution for Metronidazole Susceptibility Testing of Helicobacter Pylori: Importance of the Prevalence of Metronidazole Resistance

2021 ◽  
Author(s):  
Jinnan Chen ◽  
Yu Huang ◽  
Zhaohui Ding ◽  
Xiao Liang ◽  
Hong Lu
Keyword(s):  
Helicobacter Pylori ◽  
Susceptibility Testing ◽  
Resistance Rate ◽  
Test Method ◽  
Major Error ◽  
Metronidazole Resistance ◽  
Agar Dilution ◽  
H Pylori ◽  
High Level ◽  
Level Resistance

Abstract Background: A number of studies have shown that E-test overestimated the presence of Helicobacter pylori (H. pylori) resistance compared to agar dilution.Objective: The purpose of this study was to explore whether E-test could be an alternative for agar dilution to detect the metronidazole susceptibility of H. pylori.Method: E-test and agar dilution were used to assess susceptibility of H. pylori to metronidazole, clarithromycin and levofloxacin in 281 clinical isolates obtained from China where resistance was high. Cohen kappa analysis, McNemar test, essential and categorical agreement analysis were performed for these two methods. Results: Overall, the result of E-test showed similar prevalence of resistance rate to all antibiotics compared with agar dilution. The essential agreement (EA) of E-test method and agar dilution in the evaluation susceptibility of H. pylori to clarithromycin and levofloxacin were moderate, with 89.0% and 79.7% respectively, but only 45.9% for metronidazole. Results showed categorical agreement (CA) between E-test and agar dilution were 100% for both clarithromycin and levofloxacin. As for metronidazole, the CA was 98.7%, no major error was identified, and rate of very major error was 1.8%.Conclusion: E-test can be an alternative method to detect the metronidazole susceptibility of H. pylori in regions where high-level resistance is common.

scholarly journals 2072. Multicenter Evaluation of the Etest vs. Agar Dilution for Susceptibility Testing of Helicobacter pylori

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S605-S605
Author(s):  
Salika M Shakir ◽  
Joshua Otiso ◽  
George Keller ◽  
Hillary Van Heule ◽  
Peggy Kohner ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Susceptibility Testing ◽  
Agar Dilution

scholarly journals Variation in erythromycin and clindamycin susceptibilities of Streptococcus pneumoniae by four test methods.

1997 ◽  
Vol 41 (1) ◽  
pp. 129-134 ◽  
Author(s):  
E L Fasola ◽  
S Bajaksouzian ◽  
P C Appelbaum ◽  
M R Jacobs
Keyword(s):  
Streptococcus Pneumoniae ◽  
Susceptibility Testing ◽  
Ambient Air ◽  
Test Methods ◽  
Disk Diffusion ◽  
Broth Microdilution ◽  
Microdilution Method ◽  
Broth Microdilution Method ◽  
Agar Dilution ◽  
Resistant Strains

Susceptibilities of 124 strains of Streptococcus pneumoniae to erythromycin and clindamycin were determined by the National Committee for the Clinical Laboratory Standards (NCCLS) broth microdilution method, with incubation for 20 to 24 h in ambient air and with modifications of this method by incubation for up to 48 h in air and CO2. Strains were also tested by agar dilution, E-test, and disk diffusion; good correlation was obtained with these methods, with clear separation into bimodal populations of susceptible and resistant stains. The broth microdilution method, however, using incubation in air for 24 h (NCCLS method), misclassified 4 of 92 erythromycin-resistant strains (1 as susceptible and 3 as intermediate) and 25 of 58 clindamycin-resistant strains (all as susceptible). With the exception of one strain with clindamycin, susceptible and resistant strains were correctly classified by the microdilution method with incubation in CO2 for 24 h or in ambient air for 48 h. Disk diffusion, agar dilution, and E-test methods with incubation in 5% CO2 are therefore reliable methods for susceptibility testing of pneumococci against these agents. However, the NCCLS microdilution method, which specifies incubation for 20 to 24 h in ambient air, produced significant very major errors (43%) clindamycin. Modification of the microdilution method by incubation in 5% CO2 or by extension of incubation time in ambient air to 48 h corrected these errors. Disk diffusion, however, was shown to be a simple, convenient, and reliable method for susceptibility testing of pneumococci to erythromycin and clindamycin and is suggested as the method of choice for these agents.

scholarly journals Antimicrobial Susceptibility of Helicobacter pylori Determined by the E Test Using Tetrazolium Egg Yolk Agar

1998 ◽  
Vol 36 (9) ◽  
pp. 2784-2785 ◽  
Author(s):  
Yanet Valdez ◽  
Billie Velapatiño ◽  
Robert H. Gilman ◽  
Vilma Gutierrez ◽  
Carlos León
Keyword(s):  
Helicobacter Pylori ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Agar Medium ◽  
Egg Yolk ◽  
Blood Agar ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Agar Dilution ◽  
H Pylori

Metronidazole and tetracycline E tests were compared to an agar dilution method for the antimicrobial susceptibility testing ofHelicobacter pylori. Sixteen strains were tested by using tetrazolium egg yolk (TEY) agar. The characteristic E test inhibition ellipse was clearer on TEY agar than on standard blood agar and gave results comparable to those of the agar dilution test. The use of TEY medium is preferable to that of blood agar medium in E test MIC determinations for H. pylori.

scholarly journals Antimicrobial susceptibility testing of 230 Helicobacter pylori strains: importance of medium, inoculum, and incubation time.

1997 ◽  
Vol 41 (12) ◽  
pp. 2634-2639 ◽  
Author(s):  
S H Hartzen ◽  
L P Andersen ◽  
A Bremmelgaard ◽  
H Colding ◽  
M Arpi ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Incubation Time ◽  
Susceptibility Testing ◽  
Development Of Resistance ◽  
Mueller Hinton ◽  
Mueller Hinton Agar ◽  
Agar Dilution ◽  
Horse Blood ◽  
Preliminary Study ◽  
H Pylori

No standardized method of susceptibility testing for Helicobacter pylori is currently available, so before a large agar dilution study comprising 230 H. pylori strains belonging to more than 80 genetically different groups was initiated, we performed a relatively small preliminary study to determine the influences of medium, inoculum density, and incubation time. Seven media were investigated and were primarily evaluated on the basis of their abilities to support growth both semiquantitatively and qualitatively; Iso-Sensitest agar supplemented with 10% horse blood was found to be well suited for the purpose; this was closely followed by Mueller-Hinton agar with 10% horse blood, Mueller-Hinton with 10% sheep blood, and finally, 7% lysed horse blood agar. Investigations of two inoculum densities and two incubation times resulted in recommendations for the use of 10(9) CFU/ml (10[6] CFU/spot) as the inoculum and 72 h as the incubation time. A modest inoculum effect was noted for amoxicillin and metronidazole. By the methodology derived from our preliminary study, the susceptibilities of 230 H. pylori strains to six antibiotics were subsequently determined. The results were generally in accord with those of others, and apart from metronidazole, the MIC of which for approximately 25% of the strains tested was >8 microg/ml, resistance was low in Denmark. The situation might, however, quickly change when and if the number of indications for antibiotic therapy for H. pylori infections increase. Consequently, susceptibility testing of all H. pylori strains is recommended in order to survey the development of resistance, and in our hands the described methodology was relatively easy to perform and the results were easy to read.

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