Comparison of the Vitek GPS-TB Card With Disk Diffusion Testing for Predicting the Susceptibility of Enterococci to Vancomycin

1999 ◽  
Vol 123 (7) ◽  
pp. 622-625
Author(s):  
Natalie Williams-Bouyer ◽  
Barbara S. Reisner ◽  
Carla E. Woodmansee ◽  
Pamela S. Falk ◽  
C. Glen Mayhall

Abstract Objective.—To compare the ability of the Vitek GPS-TB card with disk diffusion testing for determining the susceptibility of enterococci to vancomycin. Design.—Vitek susceptibility testing was performed using the GPS-TB card and software version R05.03. Disk diffusion susceptibility testing was performed according to National Committee for Clinical Laboratory Standards guidelines. When discrepancies occurred between the interpretation of Vitek and disk diffusion, both tests were repeated and the epsilometer test (E test) and agar screen containing 6 μg/mL vancomycin were performed. Results.—Of 415 isolates tested, 313 were susceptible to vancomycin and 97 were resistant to vancomycin by both test methods. Two isolates were intermediate by Vitek and resistant by disk diffusion, 2 were intermediate by Vitek and susceptible by disk diffusion, and 1 was susceptible by Vitek and intermediate by disk diffusion. All but 1 of these latter 5 isolates (intermediate by Vitek and susceptible by disk diffusion) were available for retesting. On repeat testing, the 2 isolates that were intermediate by Vitek and resistant by disk diffusion were resistant by both methods, the 1 isolate that was intermediate by Vitek and susceptible by disk diffusion was susceptible by both methods, and the isolate that was susceptible by Vitek and intermediate by disk diffusion was also susceptible by both methods. These results were confirmed by E test and agar screen. Conclusion.—We found the results of the GPS-TB card compared well with disk diffusion. However, isolates with intermediate results by Vitek should be retested using another method, such as the E test.

1996 ◽  
Vol 8 (3) ◽  
pp. 337-344 ◽  
Author(s):  
Thomas R. Shryock ◽  
Donald W. White ◽  
J. Mitchell Staples ◽  
Carolyn S. Werner

Tilmicosin is a novel macrolide antibiotic developed for exclusive use in veterinary medicine. The first tilmicosin-containing product was approved to treat bovine respiratory disease associated with pasteurellae. The development of antimicrobial susceptibility testing guidelines for tilmicosin was predicated on the relationship of clinical efficacy studies that demonstrated a favorable therapeutic outcome, on pharmacokinetic data, and on in vitro test data, as recommended by the National Committee for Clinical Laboratory Standards (NCCLS). The NCCLS-approved breakpoints for the MIC dilution testing are resistant ‡ 32 g/ml, intermediate 16 g/ml, and susceptible £ 8 g/ml. The zone of inhibition interpretive criteria for disk diffusion testing with a 15- g disk are resistant £ 10 mm, intermediate 11–13 mm, and susceptible ‡ 14 mm.


1999 ◽  
Vol 37 (12) ◽  
pp. 4051-4058 ◽  
Author(s):  
Fred C. Tenover ◽  
Ronald N. Jones ◽  
Jana M. Swenson ◽  
Barbara Zimmer ◽  
Sigrid McAllister ◽  
...  

A multilaboratory study was undertaken to determine the accuracy of the current National Committee for Clinical Laboratory Standards (NCCLS) oxacillin breakpoints for broth microdilution and disk diffusion testing of coagulase-negative staphylococci (CoNS) by using a PCR assay for mecA as the reference method. Fifty well-characterized strains of CoNS were tested for oxacillin susceptibility by the NCCLS broth microdilution and disk diffusion procedures in 11 laboratories. In addition, organisms were inoculated onto a pair of commercially prepared oxacillin agar screen plates containing 6 μg of oxacillin per ml and 4% NaCl. The results of this study and of several other published reports suggest that, in order to reliably detect the presence of resistance mediated bymecA, the oxacillin MIC breakpoint for defining resistance in CoNS should be lowered from ≥4 to ≥0.5 μg/ml and the breakpoint for susceptibility should be lowered from ≤2 to ≤0.25 μg/ml. In addition, a single disk diffusion breakpoint of ≤17 mm for resistance and ≥18 mm for susceptibility is suggested. Due to the poor sensitivity of the oxacillin agar screen plate for predicting resistance in this study, this test can no longer be recommended for use with CoNS. The proposed interpretive criteria for testing CoNS have been adopted by the NCCLS.


2000 ◽  
Vol 38 (9) ◽  
pp. 3341-3348 ◽  
Author(s):  
Julia A. Kiehlbauch ◽  
George E. Hannett ◽  
Max Salfinger ◽  
Wendy Archinal ◽  
Catherine Monserrat ◽  
...  

Accurate antimicrobial susceptibility testing is vital for patient care and surveillance of emerging antimicrobial resistance. The National Committee for Clinical Laboratory Standards (NCCLS) outlines generally agreed upon guidelines for reliable and reproducible results. In January 1997 we surveyed 320 laboratories participating in the New York State Clinical Evaluation Program for General Bacteriology proficiency testing. Our survey addressed compliance with NCCLS susceptibility testing guidelines for bacterial species designated a problem (Staphylococcus aureus and Enterococcusspecies) or fastidious (Streptococcus pneumoniae,Haemophilus influenzae, and Neisseria gonorrhoeae) organism. Specifically, we assessed compliance with guidelines for inoculum preparation, medium choice, number of disks per plate, and incubation conditions for disk diffusion tests. We also included length of incubation for S. aureus andEnterococcus species. We found overall compliance with the five characteristics listed above in 80 of 153 responding laboratories (50.6%) for S. aureus and 72 of 151 (47.7%) laboratories for Enterococcus species. The most common problem was an incubation time shortened to less than 24 h. Overall compliance with the first four characteristics was reported by 92 of 221 (41.6%) laboratories for S. pneumoniae, 49 of 163 (30.1%) laboratories for H. influenzae, and 11 of 77 (14.3%) laboratories for N. gonorrhoeae. Laboratories varied from NCCLS guidelines by placing an excess number of disks per plate. Laboratories also reported using alternative media forEnterococcus species, N. gonorrhoeae, andH. influenzae. This study demonstrates a need for education among clinical laboratories to increase compliance with NCCLS guidelines.


2000 ◽  
Vol 38 (1) ◽  
pp. 453-455
Author(s):  
Brant A. Odland ◽  
Meredith E. Erwin ◽  
Ronald N. Jones

ABSTRACT This multicenter study proposes antimicrobial susceptibility (MIC and disk diffusion methods) quality control (QC) parameters for seven compounds utilized in veterinary health. Alexomycin, apramycin, tiamulin, tilmicosin, and tylosin were tested by broth microdilution against various National Committee for Clinical Laboratory Standards (NCCLS)-recommended QC organisms ( Staphylococcus aureus ATCC 29213, Enterococcus faecalis ATCC 29212, Streptococcus pneumoniae ATCC 49619, Escherichia coli ATCC 25922, and Pseudomonas aeruginosa ATCC 27853). In addition, disk diffusion zone diameter QC limits were determined for apramycin, enrofloxacin, and premafloxacin by using E. coli ATCC 25922, P. aeruginosa ATCC 27853, and S. aureus ATCC 25923. The results from five or six participating laboratories produced ≥99.0% of MICs and ≥95.0% of the zone diameters within suggested guidelines. The NCCLS Subcommittee for Veterinary Antimicrobial Susceptibility Testing has recently approved these ranges for publication in the next M31 document.


2005 ◽  
Vol 49 (1) ◽  
pp. 82-87 ◽  
Author(s):  
Ruben Avendaño-Herrera ◽  
Rute Irgang ◽  
Soledad Núñez ◽  
Jesús L. Romalde ◽  
Alicia E. Toranzo

ABSTRACT In the present study, Anacker and Ordal agar, marine agar (MA), and Flexibacter maritimus medium (FMM) were compared with the dilute versions of Mueller-Hinton agar (DMHA) medium recommended by the National Committee for Clinical Laboratory Standards (NCCLS) for their use in disk diffusion tests with Tenacibaculum maritimum strains and to calculate the MICs of five drugs by the Etest method. Preliminary growth tests performed with 32 strains of this pathogen on each medium revealed that all strains failed to grow on DMHA, while the remaining media supported good growth of all isolates. In the susceptibility tests, which were carried out with the other three media, all strains were resistant to oxolinic acid and were highly susceptible to amoxicillin and trimethoprim-sulfamethoxazole, showing a good correspondence with the Etest values, which ranged from 0.064 to 0.75 and 0.006 to 1.5 μg/ml, respectively. Enrofloxacin and oxytetracycline produced significantly smaller inhibition zones and MICs on MA than on the other media assayed. However, fast, clear, and well-defined zones of inhibition were displayed for all strains at 24 h of incubation only on FMM by both the disk diffusion assay and Etest. In addition, FMM prepared with commercial sea salts instead of seawater was also suitable for bacterial isolation as well as for susceptibility testing. On the basis of these results, the use of FMM to determine the in vitro susceptibility of T. maritimum and its inclusion in a future revision of the NCCLS M42 report are recommended.


2003 ◽  
Vol 47 (5) ◽  
pp. 1647-1651 ◽  
Author(s):  
Madonna J. Matar ◽  
Luis Ostrosky-Zeichner ◽  
Victor L. Paetznick ◽  
Jose R. Rodriguez ◽  
Enuo Chen ◽  
...  

ABSTRACT The activities of fluconazole and voriconazole against isolates of Candida spp. (n = 400) were tested by the E-test, disk diffusion, and the National Committee for Clinical Laboratory Standards (NCCLS) M27-A2 broth microdilution-based reference methods. More than 96% of isolates found to be susceptible to fluconazole by the reference method were identified as susceptible by the agar-based methods. Lesser degrees of correlation with the reference method were seen for isolates identified as resistant by the agar-based methods. Interpretive categories are not available for voriconazole, but results qualitatively similar to those for fluconazole were seen. The agar-based E-test and disk diffusion methods are reliable alternatives to the NCCLS M27-A2 reference microdilution method for isolates that test susceptible to fluconazole.


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 ◽  
...  

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.


2000 ◽  
Vol 44 (11) ◽  
pp. 2962-2968 ◽  
Author(s):  
J. H. Jorgensen ◽  
L. M. Weigel ◽  
J. M. Swenson ◽  
C. G. Whitney ◽  
M. J. Ferraro ◽  
...  

ABSTRACT The activities of two investigational fluoroquinolones and three fluoroquinolones that are currently marketed were determined for 182 clinical isolates of Streptococcus pneumoniae. The collection included 57 pneumococcal isolates resistant to levofloxacin (MIC ≥ 8 μg/ml) recovered from patients in North America and Europe. All isolates were tested with clinafloxacin, gatifloxacin, gemifloxacin, levofloxacin, and trovafloxacin by the National Committee for Clinical Laboratory Standards broth microdilution and disk diffusion susceptibility test methods. Gemifloxacin demonstrated the greatest activity on a per gram basis, followed by clinafloxacin, trovafloxacin, gatifloxacin, and levofloxacin. Scatterplots of the MICs and disk diffusion zone sizes revealed a well-defined separation of levofloxacin-resistant and -susceptible strains when the isolates were tested against clinafloxacin and gatifloxacin. DNA sequence analyses of the quinolone resistance-determining regions of gyrA,gyrB, parC, and parE from 21 of the levofloxacin-resistant strains identified eight different patterns of amino acid changes. Mutations among the four loci had the least effect on the MICs of gemifloxacin and clinafloxacin, while the MICs of gatifloxacin and trovafloxacin increased by up to six doubling dilutions. These data indicate that the newer fluoroquinolones have greater activities than levofloxacin against pneumococci with mutations in the DNA gyrase or topoisomerase IV genes. Depending upon pharmacokinetics and safety, the greater potency of these agents could provide improved clinical efficacy against levofloxacin-resistant pneumococcal strains.


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