scholarly journals The Poisoned Well: Enhancing the Predictive Value of Antimicrobial Susceptibility Testing in the Era of Multidrug Resistance

2017 ◽  
Vol 55 (8) ◽  
pp. 2304-2308 ◽  
Author(s):  
Thea Brennan-Krohn ◽  
Kenneth P. Smith ◽  
James E. Kirby
Keyword(s):  
Antimicrobial Susceptibility ◽  
Clinical Microbiology ◽  
Predictive Power ◽  
Susceptibility Testing ◽  
Reference Method ◽  
Antimicrobial Susceptibility Testing ◽  
Clinical Microbiology Laboratory ◽  
Microbiology Laboratory ◽  
Laboratory Reference ◽  
Doubling Dilution

ABSTRACTAntimicrobial susceptibility testing (AST) is a fundamental mission of the clinical microbiology laboratory. Reference AST methods are based on bacterial growth in antibiotic doubling dilution series, which means that any error in the reference method inherently represents at least a 2-fold difference. We describe the origins of current AST reference methodology, highlight the sources of AST variability, and propose ideas for improving AST predictive power.

scholarly journals Driving laboratory standardisation of bacterial culture and antimicrobial susceptibility testing in veterinary clinical microbiology in Europe and beyond

2020 ◽  
Author(s):  
Dorina Timofte ◽  
Els M. Broens ◽  
Luca Guardabassi ◽  
Constanca Pomba ◽  
Fergus Allerton ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
Clinical Microbiology ◽  
Susceptibility Testing ◽  
Critical Role ◽  
Diagnostic Procedures ◽  
Antimicrobial Treatment ◽  
Antimicrobial Susceptibility Testing ◽  
Clinical Microbiology Laboratory ◽  
Animal Pathogens

Globally, antimicrobial resistance is one of the most important public health challenges in which the clinical microbiology laboratory plays a critical role by providing guidance for antimicrobial treatment. Despite the recognition of its importance, there is still a real need for standardized training of clinical microbiologists and harmonisation of diagnostic procedures. This is particularly true for veterinary clinical microbiology where additional challenges exist when microbiologists are trying to fulfil a professional role very similar to their colleagues working in human microbiology laboratories. The specific points that need addressing to improve the outputs of veterinary microbiology laboratories discussed here include 1) harmonisation of methodologies used by veterinary laboratories for antimicrobial susceptibility testing (AST); 2) specific guidelines for interpretation and reporting of AST results for animal pathogens; 3) guidelines for detection of antimicrobial resistance mechanisms in animal isolates; 4) standardisation of diagnostic procedures for animal clinical specimens and 5) the need to train more veterinary clinical microbiology specialists. However, there is now a plan to address these issues led by the European Network for Optimisation of Veterinary Antimicrobial Treatment (ENOVAT) which is bringing together experts in veterinary microbiology, pharmacology, epidemiology and antimicrobial stewardship from Europe and wider afield. ENOVAT is aiming to work with project partners towards standardisation and harmonisation of laboratory methodologies and optimisation of veterinary antimicrobial treatment. Ultimately, the project may provide a mechanism for standardisation and harmonisation of veterinary clinical microbiology methodologies, which could then be used as a template for implementation at a wider international level.

scholarly journals CIM City: the Game Continues for a Better Carbapenemase Test

2019 ◽  
Vol 57 (7) ◽  
Author(s):  
Romney M. Humphries
Keyword(s):  
Antimicrobial Susceptibility ◽  
Clinical Microbiology ◽  
Susceptibility Testing ◽  
Clinical Care ◽  
Antimicrobial Susceptibility Testing ◽  
European Committee ◽  
Link Type ◽  
Clinical Laboratories ◽  
The Right

ABSTRACT The Clinical and Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing agree that carbapenemase testing is not necessary for clinical care, provided that the laboratory is up to date with current breakpoints. Nonetheless, publication on the development and modification of carbapenemase tests continues, as is the case in this issue of the Journal of Clinical Microbiology (R. W. Beresford and M. Maley, J Clin Microbiol 57:e01852-18, 2019, https://doi.org/10.1128/JCM.01852-18). This commentary explores modifications to the carbapenem inactivation method—but is this the right focus for clinical laboratories?

scholarly journals Broth Microdilution and Gradient Diffusion Strips vs. Reference Agar Dilution Method: First Evaluation for Clostridiales Species Antimicrobial Susceptibility Testing

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 975
Author(s):  
Florian Baquer ◽  
Asma Ali Sawan ◽  
Michel Auzou ◽  
Antoine Grillon ◽  
Benoît Jaulhac ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Reference Method ◽  
Antimicrobial Susceptibility Testing ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Broth Microdilution ◽  
Multicenter Studies ◽  
Gradient Diffusion ◽  
Agar Dilution

Antimicrobial susceptibility testing of anaerobes is challenging. Because MIC determination is recommended by both CLSI and EUCAST, commercial broth microdilution and diffusion strip tests have been developed. The reliability of broth microdilution methods has not been assessed yet using the agar dilution reference method. In this work, we evaluated two broth microdilution kits (MICRONAUT-S Anaerobes® MIC and Sensititre Anaerobe MIC®) and one gradient diffusion strip method (Liofilchem®) for antimicrobial susceptibility testing of 47 Clostridiales isolates (Clostridium, Clostridioides and Hungatella species) using the agar dilution method as a reference. The evaluation focused on comparing six antimicrobial molecules available in both microdilution kits. Analytical performances were evaluated according to the Food and Drug Administration (FDA) recommendations. Essential agreements (EA) and categorical agreements (CA) varied greatly according to the molecule and the evaluated method. Vancomycin had values of essential and categorical agreements above 90% for the three methods. The CA fulfilled the FDA criteria for three major molecules in the treatment of Gram-positive anaerobic infections (metronidazole, piperacillin/tazobactam and vancomycin). The highest rate of error was observed for clindamycin. Multicenter studies are needed to further validate these results.

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