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Error rates in cefoperazone and cefoperazone-sulbactam disk tests with Enterobacteriaceae and Pseudomonas aeruginosa
Abstract:
In a collaborative study involving five medical centers, 6% of 2,440 consecutive isolates of Enterobacteriaceae were resistant to cefoperazone; resistance to cefoperazone was reduced to < 1% by the addition of sulbactam. Susceptibility to cefoperazone and cefoperazone-sulbactam was accurately predicted by disk diffusion tests. Resistance to cefoperazone, however, was not as reliably detected by disk tests and results of dilution tests were not always consistent. The prevalence of resistance to cefoperazone and/or the ability to detect resistance had a significant influence on very major error rates for individual laboratories.
Insights
Cefoperazone resistance in Enterobacteriaceae was significantly reduced by adding sulbactam. Disk diffusion tests accurately predicted susceptibility but had challenges detecting cefoperazone resistance reliably.
Area of Science:
- Clinical microbiology
- Antimicrobial resistance research
- Infectious disease epidemiology
Background:
- Enterobacteriaceae infections pose a significant public health challenge.
- Emerging antibiotic resistance necessitates continuous monitoring and evaluation of treatment strategies.
Purpose of the Study:
- To assess the prevalence of cefoperazone resistance in Enterobacteriaceae.
- To evaluate the efficacy of sulbactam in combination with cefoperazone.
- To determine the accuracy of disk diffusion tests in predicting susceptibility and resistance.
Main Methods:
- Collaborative study across five medical centers.
- Analysis of 2,440 consecutive Enterobacteriaceae isolates.
- Antimicrobial susceptibility testing using disk diffusion and dilution methods.
Main Results:
- 6% of isolates were resistant to cefoperazone alone.
- Cefoperazone-sulbactam combination reduced resistance to < 1%.
- Disk diffusion accurately predicted susceptibility but showed variability in detecting cefoperazone resistance.
Conclusions:
- Cefoperazone-sulbactam is a promising combination for treating Enterobacteriaceae infections.
- Accurate detection of resistance is crucial for effective antimicrobial stewardship.
- Standardized susceptibility testing methods are essential to minimize laboratory errors.