Standardized Antimicrobial Disc Susceptibility Testing of Anaerobic Bacteria. I. Susceptibility of Bacteroides fragilis to Tetracycline

A modified Bauer-Kirby-Sherris-Turck method for disc susceptibility testing of anaerobic bacteria is presented. When tetracycline was used against 100 strains of Bacteroides fragilis as a model, reasonably reproducible results were obtained after overnight incubation in both the GasPak atmosphere and an atmosphere achieved by adding 10% CO(2) to a mixture of 10% H(2) and 90% N(2). The minimal inhibitory concentration for the strains determined by the agar dilution technique correlated well with the results of disc tests performed in the GasPak atmosphere with 30-mug tetracycline discs. Among 63 strains isolated from 1970 to the present, only 24 (38.1%) were found to be susceptible to tetracycline.     

Accuracy of the disk method for determining antimicrobic susceptibility of common Gram-negative bacilli

A standardized disk susceptibility test was evaluated by comparing results with minimal inhibitory concentrations obtained with agar dilution methods. The agar overlay method was used to test 152 Gram-negative bacilli against eight different antimicrobial agents. One to 3% of the isolates were resistant to an antimicrobic by the MIC method, but appeared to be susceptible by the disk method. Most very major discrepancies involved disk tests withProteus sp., a microorganism notoriously difficult to test reproducibly.Serratia sp. vs. the polymyxins andKlebsiella sp. vs. nitrofurantoin accounted for most other major discrepancies. With other microorganism-drug combinations, the disk test was a reasonably accurate technique for classifying bacteria into resistant or susceptible categories. Gentamicin disk tests were unsatisfactory, but when an intermediate zone category of 13–16 mm was applied, the false susceptible test results were reduced to 2.6%. Intermediate zone sizes were obtained with 6% of the disk tests; most of those isolates were resistant or susceptible but not intermediate in susceptibility. About 11% of the strains had intermediate MICs (5–20% with different drugs), but most of those strains were fully susceptible by the disk technique. *** DIRECT SUPPORT *** A01R4011 00007     

Antimicrobial susceptibility tests for anaerobic bacteria. Comparison of Wilkins-Chalgren agar reference method and a microdilution method,and determination of stability of antimicrobics frozen in broth

Susceptibility results for anaerobic bacteria obtained with a microdilution method with either Wilkins-Chalgren broth or Brain Heart Infusion broth were compared to results obtained with the reference agar dilution method proposed by the National Committee for Clinical Laboratory Standards. Results were generally comparable, but the minimal inhibitory concentrations obtained with the microdilution method were slightly lower than those obtained with the agar dilution method. Antibiotics stored in these broths in microdilution trays at-20°C were stable for up to 130 days.     

Diversifications in the Tube Dilution Test for Antibiotic Sensitivity of Microorganisms

The tube dilution method of performing antibiotic sensitivity tests is commonly employed as an accurate method for defining the minimal inhibitory concentration in relation to pathogenic organisms. It is also used as a reference for comparing minimal inhibitory concentrations with the size of the zone of inhibition in the agar diffusion test. Although surveys have shown that there is no standardized method and technique of performing the tube dilution test, it is generally assumed that all of the diversified methods will yield the same results and interpretations. With the assistance of five experts, seven different tube dilution methods were compared; 16 antibiotics, and three organisms for each antibiotic, were used. The conclusions drawn are that, although the accuracy of a single method within its own confines is acknowledged, the minimal inhibitory concentrations and interpretations cannot be interpolated from one laboratory to another where a different technique is employed. The results are frequently discrepant. It is suggested that a uniform method be developed and promulgated for general use.     

Antifungal susceptibility testing of Trichosporon beigelii to imidazole compounds

Twenty-two strains of Trichosporon beigelii have been tested for susceptibility to imidazole compounds. Ten strains were isolated from untreated genital white piedra lesions and 12 were from the same patients following treatment failure with imidazole compounds. Agar dilution and disk elution methods were compared using two media: yeast nitrogen base and antibiotic assay medium 3 (Difco). Antifungal agents tested were econazole, miconazole, ketoconazole, clotrimazole, and amphotericin B in concentrations of 0.0625-32 micrograms/mL. The most consistent results occurred with antibiotic assay medium 3 and the agar dilution method giving minimal inhibitory concentrations between 0.0625 and 0.25 micrograms/mL. Using yeast nitrogen base agar, minimal inhibitory concentrations were higher ranging from 0.0625 to 2.0 micrograms/mL. End points of growth in the disk elution method were not clearly delineated and ranged from 0.0625 to 8.0 micrograms/mL. The distribution of minimal inhibitory concentrations obtained using different media and methods were compared by chi 2 analysis, and the medium was found to significantly change the minimal inhibitory concentrations. There was no difference in the susceptibility of strains of T. beigelii to imidazole compounds whether isolated before or after treatment. It was concluded that in vitro susceptibility of T. beigelii to imidazole compounds did not necessarily predict efficacy in vivo.     

In vitro activity of propolis against Streptococcus pyogenes

Propolis, a multifunctional substance used by bees to maintain the safety of their hives, is popular for its therapeutic potential against some micro-organisms. Ethanolic extracts of two propolis specimens, collected from different areas within a region in the north-west of Italy, were examined to evaluate their antimicrobial activity against 46 Streptococcus pyogenes strains. By both agar dilution and agar diffusion methods, the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were 相似文献   

300 株鲍曼不动杆菌琼脂稀释法与纸片扩散法药敏检测结果比较

目的:比较琼脂稀释法和纸片扩散法对鲍曼不动杆菌的药敏试验结果。方法:随机挑选的300株鲍曼不动杆菌,检测其标本及科室的分布情况,并采用琼脂稀释法和纸片扩散法检测鲍曼不动杆菌对环丙沙星(CIP)、庆大霉素(CN)、阿米卡星(AK)、头孢他啶(CAZ)、头孢吡肟(FEP)、左氧氟沙星(LEV)、氨苄西林-舒巴坦(SAM)、妥布霉素(TOB)、美洛培南(MEN)、米诺环素(MH)、头孢哌酮-舒巴坦(SCF)11种抗菌药物的敏感性,比较两种检测结果的差异。结果:300株鲍曼不动杆菌主要分布在痰液标本中,共214株,占71.3%,主要来源于ICU 101株(33.7%)及脑外科59株(19.7%)。药敏检测结果显示,两种检测方法所得的SCF和MH的敏感性差异具有统计学意义(P0.05),其他9种抗菌药物的药敏检测结果差异没有统计学意义(P0.05)。结论:琼脂稀释法和纸片扩散法对鲍曼不动杆菌药敏试验结果并不完全一致,临床用药时尤其要注意SCF和MH这两种药物药敏结果的可靠性。     

Stability of minocycline,doxycycline, and tetracycline stored in agar plates and microdilution trays

When the agar dilution method is used for performing antimicrobic susceptibility tests, Mueller-Hinton agar plates may be prepared with varying concentrations of the drugs to be studied. With most antimicrobics, the plates can be prepared in advance and stored in the refrigerator for as long as four weeks. The present study documents the instability of minocycline when stored under refrigeration in agar plates. Doxycycline and tetracycline also lost activity but at a slower rate. Degradative changes occurred most rapidly at the lower concentrations; at 16 μg/ml or greater, the drugs were relatively stable. When diluted in Mueller-Hinton broth and stored at −60°C in microdilution trays, the three tetracyclines could be held up to six weeks with no loss of bioactivity. Concentrated stock solutions were kept at −60°C for six months with no loss of potency.     

Significance of anaerobic preincubation of Helicobacter pylori for measuring metronidazole susceptibility by the Etest.

The Etest is widely used for measuring the susceptibility of Helicobacter pylori to metronidazole. By using 55 H. pylori isolates from 55 patients and a standard H. pylori strain, NCTC11637, we compared metronidazole susceptibility results obtained from the Etest with or without anaerobic preincubation to those obtained from the agar dilution method. Mueller Hinton agar plates supplemented with 5% horse blood were used for both methods. For the Etest, plates were incubated for 72 hr at 35 C under microaerophilic conditions after 0-, 4- or 24-hr periods of anaerobic preincubation. For the agar dilution method, the plates were incubated at the same microaerophilic conditions as those for the Etest. Without anaerobic preincubation for the Etest, 39 of the 56 (70%) H. pylori isolates were categorized as resistant to metronidazole (minimal inhibitory concentration>8 mg/liter), whereas only one of the 56 (1.8%) isolates was resistant according to the agar dilution method. The resistant and susceptible agreement rate was 32%. Four-hour anaerobic preincubation did not alter the readings of the Etest significantly. However, when the Etest was performed with 24-hr anaerobic preincubation, the number of isolates categorized as resistant was reduced to six (11%), improving the agreement rate to 91%. For measuring the metronidazole susceptibility of H. pylori by the Etest, 24-hr anaerobic preincubation is necessary to agree with the results obtained by the agar dilution test.     

Evaluation of methods for detecting oxacillin resistance in coagulase-negative staphylococci including cefoxitin disc diffusion

The aim of this study was to evaluate the accuracy of cefoxitin disc diffusion as a prediction of oxacillin resistance in coagulase-negative staphylococci (CoNS), and also to compare genotypic and phenotypic methods for detecting this resistance property. A total of 151 clinical CoNS isolates were tested by PCR for the presence of the mecA gene (gold standard method). The isolate susceptibilities were determined by the disc diffusion method with oxacillin (1 microg) and cefoxitin (30 microg) and by the agar dilution method for cefoxitin and oxacillin. Although none of the techniques showed 100% sensitivity and 100% specificity, the cefoxitin disc diffusion and oxacillin agar dilution were the best methods for detecting resistance to oxacillin among CoNS as these methods produced the best negative and positive predictive values. A combination of methods can be used routinely to identify resistance to oxacillin in CoNS.     

Comparative study of in vitro methods to analyse the antifungal activity of propolis against yeasts isolated from patients with superficial mycoses

AIM: To test a total of 15 strains belonging to four species of yeasts by different in vitro methods against propolis and itraconazole (ITC). METHODS AND RESULTS: Three methods were compared for susceptibility testing of yeast isolates to propolis: disc diffusion method, agar dilution method and National Committee for Clinical Laboratory Standards (NCCLS, M27A) broth microdilution method. ITC was selected as the antifungal agent for comparison study. Using the broth microdilution method, the geometric mean for MIC (microg ml(-1)) with regard to all isolates was < or =0.06 for propolis and < or =0.35 for ITC. The broth microdilution and the agar dilution methods were in good agreement (75%) for propolis against yeasts isolated from patients with superficial mycoses. Using the diffusion method, all strains showed a broad zone of inhibition at the first available reading time (24 or 48 h). An increase of MIC values was accompanied by a decrease of growth inhibition zone diameter. A favourable correlation was found between MIC and inhibition zone around the disc for propolis sample and the correlation coefficient was: r = -0.626 (P < 0.01). CONCLUSIONS: This study suggests the potential value of the agar dilution and disc diffusion method as a convenient alternative method for testing of yeasts to propolis. SIGNIFICANCE AND IMPACT OF THE STUDY: This study demonstrated that propolis and ITC were very active against yeasts from patients with superficial mycoses. The other prominent finding in this study is that RPMI 1640 with L-glutamine was the available broth for the in vitro susceptibility testing of yeasts.     

Antibiotic susceptibility and occurrence of ESBL in Pseudomonas aeruginosa strains isolated from different clinical specimens

The aim of this study was to evaluate the drug susceptibility of 132 P. aeruginosa strains isolated from patients hospitalized in SPSK University Hospital in Bialystok. The isolates were obtained from clinical specimens over an 11-month period in 2001 and 2002. All the strains were identified in automatic ATB system using API 20 NE strips, and their susceptibility to antibiotics was tested by standard disc-diffusion method and agar dilution method. The minimal inhibitory concentration (MIC) was determined for five antibiotics: piperacillin, amikacin, ceftazidime, imipenem and ciprofloxacin. The majority of strains were susceptible to ceftazidime (91.7%), piperacillin combined with tazobactam (85.6%), amikacin (80.3%), meropenem and imipenem (81.8%). Many of our strains were resistant to cefotaxime (73.5%), ticarcillin (53%) and ciprofloxacin (48.5%). Also, the trial was undertaken to detect strains producing extended-spectrum beta-lactamases (ESBL) and inducible beta-lactamases (IBL) among P. aeruginosa rods isolated from different specimens. ESBL-producing strains were detected with double disc test (DDST) and combination double disc (CD) test. Clavulanate was applied as the inhibitor of these beta-lactamases. Strains producing ESBL were not found. On the other hand, as many as 127 P. aeruginosa strains (96.2%) produced inducible beta-lactamases (IBL).     

Comparison of agar dilution test,broth dilution test,and broth elution test for assaying susceptibility ofCandida spp

Biochemically and morphologically defined isolates ofCandida spp. were tested for their susceptibility to systemic antimycotics (5-flucytosine, ketoconazole, and miconazole). Three different susceptibility test techniques—the broth disc elution test, the agar dilution test, and the broth dilution test—were examined. The different assays were correlated with the broth dilution test at breakpoint concentrations. Reliability and practicability of the test systems described here were good, and the agreement with the broth dilution test was excellent. The elution test seems to be a valuable method for smaller laboratories, whereas the agar dilution test with antimycotic tablets is a particularly and comparatively inexpensive test for laboratories handling larger numbers of specimens.     

Methicillin-resistant Staphylococcus aureus (MRSA) with high resistance to mupirocin in hospitals of the Gdańsk region

Occurrence of high-level mupirocin resistance in methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from 18 hospitals in Gdańsk area was determined. The study was carried out on 190 MRSA isolated in 1997-2000 from various clinical samples. The strains were tested for high-level mupirocin resistance by 200 micrograms mupirocin disc. The minimum inhibitory concentrations (MIC) for methicillin were estimated by agar dilution. Sensitivity to other antibiotics was determined in disc-diffusion method and to vancomycin in agar dilution method additionally. The strains were typed by set of 10 experimental phages and compared by the method of PCR-RFLP analysis of coagulase gen restriction fragment length polymorphism. There were low frequency of high-level mupirocin resistance in MRSA strains (4.7%) that were found only in 3 hospitals, in 6 patients. All of them were high-resistant also to methicillin and resistant to doxycyclin, gentamycin, erytromycin, klindamycin, ciprofloksacin, rifampicin, resistant or intermediate sensitive to fusidic acid but sensitive to vancomycin, teikoplanin and bacitracin. The origin all of the MRSA strains high-resistant to mupirocin probably was the same, except one strain, because they were belonged to one genetic type and possessed the same phage pattern.     

Etest for assessing the susceptibility of filamentous fungi

The purpose of this study was to evaluate the Etest as an in vitro antifungal susceptibility test method for different moulds originating from human samples and from the environment. A total of 50 isolates (1 Acremonium, 18 Aspergillus, 2 Cladosporium, 1 Epicoccum, 15 Penicillium, 2 Scopulariopsis and 11 Trichoderma strains) were tested by the Etest. Forty-six of the tested moulds (92%) were resistant to fluconazole with minimal inhibitory concentrations (MICs) > or = 256 microg ml(-1). There were strains resistant to ketoconazole among Aspergillus niger, A. ochraceus and Cladosporium spp. with MICs > 32 microg ml(-1). For fluconazole, no differences were observed using two different inocula, while for itraconazole, ketoconazole and amphotericin B, a 1 or less step 2-fold dilution difference in MIC was seen for the most of 10 selected strains. The MICs of fluconazole and amphotericin B obtained for Trichoderma strains by the Etest and the agar dilution method were also compared. MICs for fluconazole were in agreement, while MICs for amphotericin B were higher with 1 or 2 steps of 2-fold dilutions for most of Trichoderma strains in the case of the agar dilution method.     

芒果核仁的化学成分及其抑菌活性

从杧果(Mangifera indica L.)果实核仁中分离得到6种化合物。经光谱分析及与文献对照,分别鉴定为没食子酸(1)、没食子酸甲酯(2)、没食子酸乙酯(3)、间-二没食子酸甲酯(4)、对羟基苯甲酸(5)和丁二酸单甲酯(6),它们均为首次从芒果核中获得。用琼脂平板稀释法测定了化合物1~5对7种细菌和4种真菌生长的抑制活性。结果表明,化合物1对金黄色葡萄球菌(Staphylococcus aureus)、表皮葡萄球菌(S. epidermidis)、干燥棒状杆菌(Corynebacterium xerosis)和藤黄微球菌(Micrococcus luteus)的最小抑制浓度(MIC)为50~100 µg mL-1,化合物4对绿脓杆菌(Pseudomonas aeruginosa)有抑制活性。     

Comparison of disc diffusion, Etest and agar dilution for susceptibility testing of colistin against Enterobacteriaceae

Aims: In this study, we compared different methods of colistin susceptibility testing, disc diffusion, agar dilution and Etest using a set of Enterobacteriaceae isolates that included colistin‐resistant strains. Methods and results: Susceptibility of 200 clinical isolates of Enterobacteriaceae to colistin was tested to compare agar dilution (reference method), disc diffusion (50 and 10 μg) and Etest. MICs (minimum inhibitory concentrations) were interpreted using the criteria established by the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Colistin exhibited excellent activity against Escherichia coli and E. cloacae (MIC₉₀ = 0·5 mg l^?1). In contrast, colistin was less active against Klebsiella pneumoniae (MIC₉₀ = 16 mg l^?1). Resistance rates varied from 0% in E. coli to 1·8% in E. cloacae and 13% in K. pneumoniae. High rates of very major errors were observed in the disc diffusion test using either the criteria of the Comité de l’antibiogramme de la Société Française de Microbiologie (CA‐SFM) or the criteria of the Clinical and Laboratory Standards Institute (CLSI), respectively, 3·5 and 2·5%. When the criteria of Gales et al. were applied, the number of very major errors was reduced to one (0·5%). The Etest showed good concordance with agar dilution method. Conclusion: Disc susceptibility testing methods are unreliable on detecting colistin resistance. MIC should be determined to confirm the susceptibility results by disc diffusion. Significance and Impact of the study: We recommend the determination of MIC by Etest for all multidrug‐resistant Enterobacteriaceae when colistin is required for the treatment.     

Comparison of Agar Dilution and Broth Microdilution Methods of Anaerobic Antimicrobial Susceptibility Testing using Several Veterinary Antibiotics against Clostridium perfringens Strains Originating from Porcine and Avian Sources

A broth microdilution and a reference agar dilution method was used to determine minimal inhibitory concentrations (MICs) of five veterinary antimicrobials when tested against 96 animal-derived and six American Type Culture Collection (ATCC) strains of Clostridium perfringens. These antimicrobials [bacitracin methylenedisalicylate (bacitracin-MD), tylosin, virginiamycin, erthromycin and tetracycline] are approved for use in animal feed at different levels for growth enhancement, control, and treatment of a variety of enteric diseases. For bacitracin-MD, MICs were higher using the broth microdilution method when compared to the agar dilution method. The two methods had the lowest agreement when using bacitracin-MD compared to the method agreements of other antimicrobials tested (only 34.3% of the C. perfringens tested within ±1 doubling dilution). Tylosin MICs were lower by the broth microdilution method but had better agreement between methods with 75.5% of the C. perfringens tested within ±1 doubling dilution. Good correlation between methods was found for virginiamycin, tetracycline, and erythromycin with 85.3, 76.5, 81.4% of the C. perfringens tested within ±1 doubling dilution, respectively. Differences in susceptibility to individual antimicrobials were found among the avian and porcine strains by both methods. For avian strains, bacitracin-MD, tylosin, and erthromycin MIC₉₀values had differences of at least four doubling dilutions between methods. There were biases toward higher bacitracin-MD and lower tylosin and erythromycin MIC₉₀values using the broth microdilution method. MIC₉₀values against porcine and ATCC strains were more comparable between methods for all five antimicrobials than those generated against avian strains but the biases were still present. Most animal-derived strains were inhibited by approved livestock feed levels of the antimicrobials. Caution should be used when evaluating the potential effectiveness of feed-based antimicrobials against C. perfringens when results are generated using an in vitro test that may not be in agreement with the reference agar dilution method.     

In vitro inhibitory effect of cranberry (Vaccinium macrocarpom Ait.) juice on pathogenic microorganisms

The purpose of this study was to determine the inhibitory effects of cranberry juice on pathogenic microorganisms. The microorganisms analyzed were Escherichia coli from patients with urinary infections, Salmonella spp., Listeria monocytogenes, Pseudomonas aeruginosa, and Staphylococcus aureus. The disc method was used to determine the sensitivity of bacteria to cranberry juice (CJ, both concentrated and diluted). A lawn of 10(6) cfu/ml was grown on agar surfaces in Petri dishes and on Whatman discs that had been previously saturated with CJ and CJ : water 1 : 1 to 1 : 50 juice solutions had been placed on the discs, which were cultured and incubated. The results indicated that S. aureus was more susceptible to cranberry juice inhibition than the other microorganisms. L. monocytogenes was the most resistant to the inhibitory action of cranberry juice, showing a significant difference from the inhibition of P. aeruginosa, uropathogenic E. coli, Salmonella spp., and S. aureus. This study also demonstrated that the inhibitory activity of cranberry juice for E. coli took place up to a dilution of 1 : 20.     

Screening of terrestrial and freshwater halotolerant cyanobacteria for antifungal activities

Cyanobacterial cultures tolerating 200 mmol l⁻¹ sodium chloride isolated from terrestrial and freshwater habitats of North Maharashtra region of India were evaluated for antifungal activity. Aqueous, methanol, n-propanol, and petroleum ether extracts of 40 cyanobacterial isolates belonging to nine genera were examined for inhibitory activity against five fungal pathogens. Eighteen isolates belonging to genus Oscillatoria dominated the population of halotolerant cyanobacterial cultures. Four antifungal bioassays viz. double layer agar method, disc diffusion assay, silica gel method, and minimum inhibitory concentration (MIC) were used to screen the cultures for antifungal activity. Among the solvents used, methanol extracts showed 34.9% inhibition followed by n-propanol, petroleum ether, and water exhibiting 30.2%, 18.6% and 16.2% inhibition, respectively. The double agar layer method was found to be a suitable method in preliminary screening for handling large number of cultures without extraction of compounds. However, in later screening experiments, silica gel method was seen to be advantageous over MIC and agar disc diffusion methods.