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Related Experiment Videos

Aztreonam: correlation between disk diffusion and agar plate dilutions susceptibility tests.

E C Toma, R Morisset, D Phaneuf

    Chemotherapy
    |January 1, 1985
    PubMed
    Summary

    This study correlates aztreonam disk diffusion with minimal inhibitory concentration (MIC) for gram-negative bacteria. Proposed criteria accurately distinguish susceptible from resistant isolates with zero error rates.

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    Area of Science:

    • Clinical Microbiology
    • Antimicrobial Susceptibility Testing
    • Pharmacodynamics

    Background:

    • Accurate antimicrobial susceptibility testing (AST) is crucial for guiding therapy against Gram-negative infections.
    • Aztreonam is a key antibiotic for treating infections caused by Gram-negative aerobic bacteria.
    • Disk diffusion assays offer a rapid method for AST, but require validation against quantitative methods like MIC determination.

    Purpose of the Study:

    • To establish a reliable correlation between aztreonam disk diffusion zone diameters and aztreonam minimal inhibitory concentration (MIC) values.
    • To propose and validate criteria for interpreting disk diffusion results for Gram-negative aerobic clinical isolates.
    • To assess the accuracy of proposed interpretive criteria in distinguishing susceptible from resistant bacterial strains.

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    Main Methods:

    • Regression line analysis was employed to correlate inhibitory zone diameters obtained using a 30-micrograms aztreonam disk with corresponding aztreonam MIC values.
    • Error rate-bounded analyses were performed to ensure the robustness of the correlation.
    • Proposed interpretive criteria were applied to clinical isolates to determine false-susceptible and false-resistant rates.

    Main Results:

    • A strong negative correlation (coefficient of -0.81) was observed between zone diameters and MIC values.
    • Preliminary interpretive criteria were proposed: susceptible (≥22 mm, MIC ≤8 µg/ml), intermediate (16-21 mm, MIC = 16 µg/ml), and resistant (≤15 mm, MIC ≥32 µg/ml).
    • Application of these criteria resulted in zero false-susceptible and zero false-resistant isolates.

    Conclusions:

    • The study demonstrates a strong correlation between aztreonam disk diffusion zone sizes and MICs for Gram-negative aerobic isolates.
    • The proposed interpretive criteria are highly accurate for differentiating aztreonam susceptibility and resistance.
    • These validated criteria can reliably guide clinical decisions for aztreonam therapy.