Evaluation of Alamar colorimetric MIC method for antimicrobial susceptibility testing of gram-negative bacteria

The Alamar (Alamar Biosciences, Inc., Sacramento, Calif.) colorimetric antimicrobial susceptibility testing method is a new approach to the determination of broth microdilution MICs. The method uses a color indicator to detect growth of microorganisms within the wells of a microdilution tray. The color changes can be read visually or with a fluorometer. The system contains growth and sterility control wells and 20 antimicrobial agents per MIC tray with eight twofold dilutions for each antimicrobial agent. We tested 186 multiresistant, gram-negative bacterial isolates against 33 antimicrobial agents and compared the results to those obtained by agar dilution. Categorical agreement for all agents was 90.9% and ranged from 78.2% for ampicillin-sulbactam to 98.1% for amikacin. Percent agreement for MIC results (within +/- 1 log2 dilution) was 91.0% for all agents and ranged from 69.1% for gentamicin to 97.9% for ciprofloxacin. Most of the disagreements were with the penicillins and cephalosporins for beta-lactamase-producing strains. The Alamar MIC system is very easy to read visually and appears to be a satisfactory addition to currently used MIC determination methods.