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Related Experiment Videos

In vitro studies with cefotaxime: disk diffusion susceptibility tests.

S Shadomy, E L Chan

    Journal of Clinical Microbiology
    |August 1, 1982
    PubMed
    Summary
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    Conflicting cefotaxime disk diffusion criteria were evaluated. The National Committee for Clinical Laboratory Standards (NCCLS) criteria proved more accurate than older package insert criteria for predicting bacterial susceptibility to cefotaxime.

    Area of Science:

    • Clinical microbiology
    • Antimicrobial susceptibility testing
    • Bacterial resistance mechanisms

    Background:

    • Two sets of interpretive criteria for the 30-mug cefotaxime diffusion disk existed, causing confusion.
    • These criteria, from the National Committee for Clinical Laboratory Standards (NCCLS) and product package inserts, differed in minimal inhibitory concentration (MIC) and zone size breakpoints.
    • A recent revision of package insert criteria further complicated interpretation.

    Purpose of the Study:

    • To evaluate the accuracy of two existing cefotaxime disk diffusion interpretive criteria.
    • To compare the reliability of NCCLS and original package insert criteria in predicting bacterial susceptibility.
    • To identify discrepancies and recommend improvements for cefotaxime susceptibility testing.

    Main Methods:

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    • Paired agar dilution (World Health Organization-International Collaborative Study) and disk diffusion tests (Food and Drug Administration) were performed.
    • 347 clinical isolates of aerobic bacteria were tested.
    • Results were analyzed based on established NCCLS susceptibility guidelines (MIC

    Main Results:

    • Of 347 isolates, 274 (79%) were susceptible, 61 intermediate, and 12 resistant to cefotaxime by agar dilution.
    • Original package insert criteria were unreliable for intermediate organisms (5/61 correctly predicted).
    • NCCLS criteria demonstrated better accuracy in predicting intermediate (41/61) and resistant (12/12) isolates.

    Conclusions:

    • The original package insert criteria for cefotaxime disk diffusion were overly conservative and inaccurate.
    • NCCLS criteria provide a more reliable method for interpreting cefotaxime susceptibility.
    • Standardization and revision of interpretive criteria are crucial for accurate antimicrobial susceptibility testing.