Evaluation of sulbactam-durlobactam disk diffusion and broth microdilution methods for Acinetobacter baumannii
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Xiaolan Hong1, Xinying Wang2, Xin Xiang3
1Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China; Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, Shanghai, China; Joint Laboratory of Hospital & Enterprise for Pathogen Diagnosis of Drug-resistant Bacterial Infections and Innovative Drug R&D, Shanghai, China; Medical Laboratory, The 910 Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Quanzhou, Fujian, China.
Objective:
The broth microdilution method was used as a reference method to evaluate the accuracy of sulbactam-durlobactam disk diffusion method for A. baumannii.
Methods:
In 2023, 504 nonduplicated A. baumannii isolated from 59 hospitals in China were tested by broth microdilution (M07) and disk diffusion method (M02) (10/10 µg) according to the CLSI M100 Ed34 standard. Categorical agreement (CA), minor error (mE), major error (ME), and very major error (VME) were calculated.
Results:
By broth microdilution, the susceptibility, intermediate, and resistance proportions of A. baumannii against sulbactam-durlobactam were 98.4% (496/504),1% (5/504), and 0.6% (3/504), respectively. Compared to broth microdilution method, the CA and mE of all A. baumannii isolates detected by the disk diffusion method were 99.6% (502/504) and 0.4% (2/504), respectively, with no ME or VME. For carbapenem-susceptible A. baumannii, the CA of the disk diffusion method was 100% (184/184), with no mE and ME. For carbapenem-resistant A. baumannii, the CA and mE were 99.4% (318/320) and 0.6% (2/320), respectively, with no ME or VME. For difficult-to-treat resistant A. baumannii, the CA and mE were 99.2% (249/251) and 0.8% (2/251), respectively, with no ME or VME. For colistin-resistant A. baumannii, the disk diffusion method showed a CA of 100% (12/12) with no mE, ME, or VME.
Conclusions:
The disk diffusion method (10/10 µg) accurately detects the susceptibility of A. baumannii to sulbactam-durlobactam. This method is characterised by its simplicity, economy, and ease of result interpretation, making it suitable for use in routine clinical microbiology laboratories.
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