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Related Experiment Videos

Evaluation of the E test by using selected gram-positive bacteria.

J H Ngui-Yen1, E A Bryce, C Porter

  • 1Medical Microbiology, Vancouver General Hospital, British Columbia, Canada.

Journal of Clinical Microbiology
|August 1, 1992
PubMed
Summary

The E test accurately determines minimum inhibitory concentrations (MICs) for gram-positive bacteria, offering a reliable, reproducible, and cost-effective alternative to standard methods for antibiotic susceptibility testing.

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Area of Science:

  • Microbiology
  • Clinical Laboratory Science
  • Antimicrobial Resistance

Background:

  • Accurate determination of antibiotic minimum inhibitory concentrations (MICs) is crucial for effective treatment of bacterial infections.
  • Standard reference methods for MIC determination can be time-consuming and costly.
  • The E test offers a potential alternative for MIC determination.

Purpose of the Study:

  • To evaluate the accuracy, reproducibility, and cost-effectiveness of the E test compared to standard reference methods for MIC determination.
  • To assess the E test's performance against various gram-positive bacteria, including Streptococcus pneumoniae, Enterococcus faecium, and Staphylococcus aureus (both oxacillin-sensitive and resistant).

Main Methods:

  • The E test was compared with National Committee for Clinical Laboratory Standards (NCCLS) recommended reference methods.

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  • MICs were determined for four antibiotics against 208 clinical isolates of gram-positive bacteria.
  • Evaluation included MIC accuracy, reproducibility testing, and cost analysis.
  • Main Results:

    • High agreement rates were observed between the E test and reference methods for most bacteria-antibiotic combinations (e.g., 94% for S. pneumoniae/penicillin G, 92% for E. faecium/ampicillin, 100% for E. faecium/vancomycin).
    • Use of salt-supplemented Mueller-Hinton agar improved oxacillin E test accuracy with staphylococci (85-100% agreement).
    • The E test demonstrated excellent reproducibility and was more cost-effective than microdilution panels for testing fewer than three antibiotics.

    Conclusions:

    • The E test is a simple, reliable, reproducible, and cost-effective method for MIC determination in clinical microbiology laboratories.
    • It provides accurate MIC values for a range of gram-positive organisms, aiding in appropriate antibiotic selection.
    • The E test is a valuable tool for antibiotic susceptibility testing, particularly in resource-limited settings or for routine testing of a limited number of agents.