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Antimicrobial Susceptibility Testing for Staphylococcus lugdunensis.

Joanne S K Teh1,2, Ioanna Pantelis1,2, Xiao Chen1,2

  • 1Flinders Medical Centregrid.414925.f, Department of Microbiology and Infectious Diseases, Adelaide, South Australia, Australia.

Journal of Clinical Microbiology
|October 27, 2021
PubMed
Summary
This summary is machine-generated.

Disc diffusion testing showed higher accuracy for penicillin and oxacillin susceptibility in Staphylococcus lugdunensis compared to automated methods. This study highlights disc diffusion as a more reliable method for guiding antibiotic treatment decisions.

Keywords:
CLSIEUCASTStaphylococcus lugdunensisVitek 2antimicrobial susceptibility testingblaZmecA

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Area of Science:

  • Microbiology
  • Clinical Diagnostics
  • Antimicrobial Resistance

Background:

  • Accurate antibiotic susceptibility testing is crucial for effective treatment of Staphylococcus lugdunensis infections.
  • Discrepancies exist between phenotypic testing methods and genotypic resistance mechanisms.
  • Evaluating diagnostic methods for common antibiotics like penicillin and oxacillin is essential.

Purpose of the Study:

  • To compare the accuracy of disc diffusion and automated broth microdilution for penicillin and oxacillin susceptibility testing in Staphylococcus lugdunensis.
  • To evaluate the performance of EUCAST and CLSI penicillin susceptibility testing guidelines.
  • To assess the utility of cefoxitin disc diffusion for predicting oxacillin resistance.

Main Methods:

  • Susceptibility testing of 200 Staphylococcus lugdunensis isolates using penicillin disc diffusion (1 IU and 10 IU), nitrocefin discs, cefoxitin discs, and automated broth microdilution (Vitek 2).
  • Reference methods included blaZ and mecA PCR.
  • Comparison of results from different phenotypic methods against genotypic reference standards.

Main Results:

  • Disc diffusion showed high correlation with blaZ PCR for penicillin susceptibility, with few major or very major errors.
  • Vitek 2 automated broth microdilution overestimated penicillin resistance in blaZ-negative isolates.
  • Cefoxitin disc diffusion and Vitek 2 showed categorical agreement for oxacillin resistance in mecA-positive isolates, but Vitek 2 misidentified mecA-negative isolates as resistant.

Conclusions:

  • Automated broth microdilution (Vitek 2) overestimated penicillin and oxacillin resistance in Staphylococcus lugdunensis compared to disc diffusion and PCR.
  • Disc diffusion with zone edge interpretation demonstrated superior accuracy and specificity for S. lugdunensis susceptibility testing.
  • Disc diffusion is a more reliable method for guiding antimicrobial therapy for S. lugdunensis infections.