Comparison of disk diffusion and broth microdilution methods for antimicrobial susceptibility testing of...

The aim of this study was to compare the disk diffusion (DD) and the broth microdilution (BMD) methods in determining the antimicrobial susceptibility of 36 Campylobacter isolates of meat-origin to six antibacterial drugs (erythromycin, ciprofloxacin, tetracycline, streptomycin, gentamicin and nalidixic acid). All the available zone diameter and minimum inhibitory concentration (MIC) breakpoints of C. jejuni and C. coli as recommended by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) were utilized. In addition, the zone diameter breakpoints of Enterobacterales for nalidixic acid, gentamicin, and streptomycin, as recommended by the Clinical and Laboratory Standards Institute (CLSI), were applied. All Campylobacter isolates were categorised as susceptible to erythromycin and gentamicin by both methods indicating completely concordant classification results. The overall highest 'Very major error' (VME) and 'Major error' (ME) rates were detected for nalidixic acid (13.3%) and tetracycline (26.3%), respectively, whereas a 'Minor error' (mE) rate was detected only for ciprofloxacin (60.1%). However, the Cohen's kappa statistic indicated a substantial concordance between the DD and BMD classification results for tetracycline and streptomycin, and almost perfect agreement for nalidixic acid, with corresponding categorical agreement rates of over 86% and approximately up to 92%. The correlation between the complementary inhibition zones and MIC breakpoints was strong and statistically highly significant (p < 0.001) for ciprofloxacin, tetracycline, streptomycin, and nalidixic acid.