scholarly journals Ceftazidime-avibactam and Meropenem Double Disk Diffusion Test for Identifying Carbapanem-Resistant Enterobacteriaceae and Distinguishing Between Serine and Metallo-β-Lactamase Producing Organisms

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S375-S375
Author(s):  
Lynn-Yao Lin ◽  
Ian Critchley ◽  
David Melnick
Keyword(s):  
Enterobacter Cloacae ◽  
Disk Diffusion ◽  
Screening Methods ◽  
Diffusion Test ◽  
Disk Diffusion Test ◽  
Carbapenem Resistant ◽  
The Us ◽  
Susceptible Control ◽  
Carbapenem Resistant Enterobacteriaceae ◽  
Selection Of

Abstract Background Early detection of carbapenem-resistant Enterobacteriaceae(CRE) is crucial for selection of effective treatment. While KPC is the most prevalent carbapenemase in the US, phenotypic screening methods, such as the carbapenemase inactivation method (CIM) and CarbaNP, cannot easily distinguish between serine and metallo-β-lactamases (MBL). The aim of this study was to evaluate a simple double disk diffusion (DD) test to confirm carbapenem (meropenem) resistance (MER disk) and that resistance was due to a serine carbapenemase as indicated by susceptibility to ceftazidime-avibactam (CAZ-AVI disk). MBL-producing organisms are likely to be resistant to both MER and CAZ-AVI. Methods In total, 83 clinical isolates of Enterobacteriaceae were selected for the validation: 54 Klebsiella pneumoniae (KP), 16 Enterobacter cloacae (ECL) and 13 Escherichia coli (EC). All isolates were screened for specific β-lactamase genes (Checkpoints, Wageningen, Netherlands) and included KPC, OXA, IMP, VIM, NDM as well as strains with KPC and alterations on OmpK35 and OmpK36. Isolates were tested for susceptibility to MER and CAZ-AVI by disk diffusion and broth microdilution (BMD) per CLSI guidelines. Results were analyzed to evaluate suitability of the DD test to distinguish between serine and MBL-producing organisms. Results Overall correlation between disk and BMD was 97–100% for CAZ-AVI and 94–100% for MER. Among the 50 CRE that were susceptible to CAZ-AVI were strains positive for KPC, or OXA, or in combination with ESBLs. Among the 16 isolates that were resistant to both CAZ-AVI and MER were strains that produced MBLs such as IMP, VIM and NDM and included strains with alteration in OmpK35 and OmpK36. Among the 17 carbapenem-susceptible control strains all were susceptible to both agents and were positive for AmpC or ESBLs. Conclusion The CAZ-AVI and MER DD test was successful in confirming CRE phenotype and in distinguishing between serine carbapenemase-producing and MBL-producing organisms. The test will be useful in screening patients in future trials to evaluate the efficacy of CAZ-AVI in global CRE studies where MBL’s are more prevalent in other geographic regions. Both disks are commercially available and can be performed in most clinical laboratories. Disclosures L. Y. Lin, Allergan plc: Employee, Salary; I. Critchley, Allergan plc: Employee, Salary; D. Melnick, Allergan plc: Employee, Salary

scholarly journals Comparative Evaluation of the VITEK 2, Disk Diffusion, Etest, Broth Microdilution, and Agar Dilution Susceptibility Testing Methods for Colistin in Clinical Isolates, Including Heteroresistant Enterobacter cloacae and Acinetobacter baumannii Strains

2007 ◽  
Vol 51 (10) ◽  
pp. 3726-3730 ◽  
Author(s):  
Jerome R. Lo-Ten-Foe ◽  
Anne Marie G. A. de Smet ◽  
Bram M. W. Diederen ◽  
Jan A. J. W. Kluytmans ◽  
Peter H. J. van Keulen
Keyword(s):  
Acinetobacter Baumannii ◽  
Susceptibility Testing ◽  
Enterobacter Cloacae ◽  
Clinical Isolates ◽  
Disk Diffusion ◽  
Broth Microdilution ◽  
Diffusion Test ◽  
Disk Diffusion Test ◽  
Agar Dilution ◽  
Vitek 2

ABSTRACT Increasing antibiotic resistance in gram-negative bacteria has recently renewed interest in colistin as a therapeutic option. The increasing use of colistin necessitates the availability of rapid and reliable methods for colistin susceptibility testing. We compared seven methods of colistin susceptibility testing (disk diffusion, agar dilution on Mueller-Hinton [MH] and Isosensitest agar, Etest on MH and Isosensitest agar, broth microdilution, and VITEK 2) on 102 clinical isolates collected from patient materials during a selective digestive decontamination or selective oral decontamination trial in an intensive-care unit. Disk diffusion is an unreliable method to measure susceptibility to colistin. High error rates and low levels of reproducibility were observed in the disk diffusion test. The colistin Etest, agar dilution, and the VITEK 2 showed a high level of agreement with the broth microdilution reference method. Heteroresistance for colistin was observed in six Enterobacter cloacae isolates and in one Acinetobacter baumannii isolate. This is the first report of heteroresistance to colistin in E. cloacae isolates. Resistance to colistin in these isolates seemed to be induced upon exposure to colistin rather than being caused by stable mutations. Heteroresistant isolates could be detected in the broth microdilution, agar dilution, Etest, or disk diffusion test. The VITEK 2 displayed low sensitivity in the detection of heteroresistant subpopulations of E. cloacae. The VITEK 2 colistin susceptibility test can therefore be considered to be a reliable tool to determine susceptibility to colistin in isolates of genera that are known not to exhibit resistant subpopulations. In isolates of genera known to (occasionally) exhibit heteroresistance, an alternative susceptibility testing method capable of detecting heteroresistance should be used.

scholarly journals Selection of Zone Size Interpretive Criteria for Disk Diffusion Susceptibility Tests of Three Antibiotics against Streptococcus pneumoniae, Using the New Guidelines of the National Committee for Clinical Laboratory Standards

2002 ◽  
Vol 46 (2) ◽  
pp. 398-401 ◽  
Author(s):  
Peter C. Fuchs ◽  
Arthur L. Barry ◽  
Steven D. Brown
Keyword(s):  
Streptococcus Pneumoniae ◽  
Clinical Laboratory ◽  
Disk Diffusion ◽  
National Committee ◽  
Diffusion Test ◽  
Disk Diffusion Test ◽  
New Guidelines ◽  
Susceptibility Tests ◽  
Disk Test ◽  
Selection Of

ABSTRACT Disk diffusion and broth microdilution susceptibility tests were performed with cefotaxime, ceftriaxone, telithromycin, and erythromycin (control) against 407 selected isolates of Streptococcus pneumoniae. Scattergrams were prepared from the results of these tests, and the current NCCLS guidelines for setting disk diffusion test interpretive criteria were applied. Erythromycin zone diameter breakpoints were confirmed. Telithromycin interpretive criteria for the disk test could be easily set with acceptable discrepancy rates. For cefotaxime and ceftriaxone, the minor discrepancy rates for MICs in the intermediate category ± 1 dilution were far in excess of the acceptable 40% limit, i.e., 52 and 71%, respectively. We conclude that the 30-μg disk of these two drugs cannot be reliably used to test pneumococci.

scholarly journals Evaluation of Mannitol Salt Agar for Detection of Oxacillin Resistance in Staphylococcus aureus by Disk Diffusion and Agar Screening

1998 ◽  
Vol 36 (8) ◽  
pp. 2254-2257 ◽  
Author(s):  
Günter Kampf ◽  
Christoph Lecke ◽  
Ann-Katrin Cimbal ◽  
Klaus Weist ◽  
Henning Rüden
Keyword(s):  
Staphylococcus Aureus ◽  
Disk Diffusion ◽  
Diffusion Test ◽  
Mannitol Salt Agar ◽  
Disk Diffusion Test ◽  
Zone Diameter ◽  
Oxacillin Resistance

Mannitol salt agar was evaluated for detection of oxacillin resistance in 136 Staphylococcus aureus isolates. AllmecA-positive isolates (n = 54) were correctly categorized as oxacillin resistant by the disk diffusion test (1-μg disk; zone diameter, <16 mm); the specificity was 97.6%. Agar screening (2 μg of oxacillin per ml) revealed a sensitivity of 98.1% and a specificity of 95.1%.

An alternative disk diffusion test in broth and macrodilution method for colistin susceptibility in Enterobacteriales

2019 ◽  
Vol 167 ◽  
pp. 105765
Author(s):  
López-Jácome Luis Esaú ◽  
Rengel-Garcia Christian Rodolfo ◽  
Hernández-Durán Melissa ◽  
Colín-Castro Claudia Adriana ◽  
García-Contreras Rodolfo ◽  
...  
Keyword(s):  
Disk Diffusion ◽  
Diffusion Test ◽  
Disk Diffusion Test

scholarly journals Ceftaroline resistance in Staphylococcus pseudintermedius gene mecA carriers

2018 ◽  
Vol 38 (12) ◽  
pp. 2233-2236
Author(s):  
Carolina B. Scherer ◽  
Larissa S. Botoni ◽  
Antônio U. Carvalho ◽  
Kelly M. Keller ◽  
Adriane P. Costa-Val
Keyword(s):  
Methicillin Resistance ◽  
Meca Gene ◽  
Disk Diffusion ◽  
Diffusion Test ◽  
Staphylococcus Pseudintermedius ◽  
Ceftaroline Fosamil ◽  
Disk Diffusion Test ◽  
Methicillin Resistant ◽  
Resistant Strains ◽  
Current Report

ABSTRACT: Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) being a constant concern, ceftaroline fosamil has been recently approved as a new cephalosporin, active against MRSA, for use in humans; only rare cases of resistance have been reported till date. There is no report of resistance to ceftaroline in Staphylococcus pseudintermedius, which is the main bacterium causing dermatitis and otitis in dogs. To evaluate staphylococcal resistance to ceftaroline, 35 isolates of methicillin-resistant S. pseudintermedius (MRSP), carrying the mecA gene, from 26 dogs with folliculitis and nine dogs with external otitis, underwent disk diffusion test with cefoxitin, oxacillin, and ceftaroline. Tests with cefoxitin and oxacillin showed > 90% sensitivity in methicillin resistance detection. In the disk diffusion test, 97.14% (34/35) were resistant to cefoxitin, 94.29% (33/35) to oxacillin, and 31.43% (11/35) to ceftaroline. Of the ceftaroline-resistant strains, 27.27% (3/11) were obtained from the ears of dogs while the rest (8/11) were from the skin. The current report is the first description of MRSP resistance to ceftaroline.

Sign in / Sign up

Export Citation Format

Share Document