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Evaluation of susceptibility testing methods for polymyxin.

Bijayini Behera1, Purva Mathur, Anupam Das

  • 1Department of Laboratory Medicine, Jai Prakash Narain Apex (JPNA) Trauma Centre, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029 India.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|January 5, 2010
PubMed
Summary
This summary is machine-generated.

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Evaluating polymyxin susceptibility testing methods for Gram-negative bacteria is crucial due to widespread resistance. The E-test and agar dilution methods show good concordance with the reference method, while disk diffusion is useful for initial screening.

Area of Science:

  • Microbiology
  • Clinical Laboratory Science
  • Antimicrobial Resistance

Background:

  • Rising antimicrobial resistance in Gram-negative bacteria necessitates evaluating older drugs like polymyxins.
  • The study addresses the need for reliable susceptibility testing methods for polymyxins B and E.
  • New Clinical and Laboratory Standards Institute (CLSI) guidelines were used for evaluation.

Purpose of the Study:

  • To evaluate various susceptibility testing methods for polymyxins B and E against Gram-negative bacteria.
  • To compare the accuracy and concordance of broth microdilution, agar dilution, E-test, and disk diffusion methods.
  • To assess the utility of different methods in the context of increasing antimicrobial resistance.

Main Methods:

  • Susceptibility testing of 281 multidrug-resistant Gram-negative bacteria (GNB) to polymyxin B using broth microdilution (BMD; reference), agar dilution, E-test, and disk diffusion.

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  • Disk diffusion testing of polymyxin B was also performed on an additional 723 MDR GNB isolates.
  • Error rates (very major and major) were calculated for each method compared to BMD.

    • Main Results:

    • Twenty-four of 281 (8.5%) isolates were resistant to polymyxin B by the reference BMD method.
    • Agar dilution and E-test demonstrated low rates of very major errors (0.7% and 1%) for polymyxin B.
    • Disk diffusion showed low error rates for both polymyxin B (1%) and polymyxin E (0.7%) for very major errors and minimal major errors.
    • Twenty-six (3.6%) of 723 GNB were resistant to polymyxin B by disk diffusion.

    Conclusions:

    • E-test and agar dilution methods exhibit good concordance with the reference broth microdilution method.
    • Disk diffusion can serve as a valuable initial screening tool in diagnostic laboratories for polymyxin susceptibility.
    • These findings support the use of validated methods for accurate polymyxin susceptibility testing in clinical settings.