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Related Experiment Videos

Ampicillin-sulbactam susceptibility testing criteria

A Barry1, M Pfaller, P Fuchs

  • 1Clinical Microbiology Institute, Tualatin, Oregon 97062.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|June 1, 1993
PubMed
Summary

This study evaluated ampicillin-sulbactam disk susceptibility testing for Enterobacteriaceae. Results indicate that higher sulbactam concentrations in disks may reduce test reliability for antibiotic resistance detection.

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Area of Science:

  • Microbiology
  • Clinical Pharmacy
  • Infectious Diseases

Background:

  • Enterobacteriaceae infections pose a significant challenge due to rising antibiotic resistance.
  • Ampicillin-sulbactam is a crucial therapeutic option, necessitating reliable susceptibility testing methods.
  • In vitro susceptibility testing is vital for guiding appropriate antibiotic selection.

Purpose of the Study:

  • To assess the in vitro susceptibility of Enterobacteriaceae isolates to ampicillin-sulbactam using disk diffusion methods.
  • To evaluate the impact of varying sulbactam concentrations on the accuracy of susceptibility testing.
  • To determine optimal disk potencies and interpretive criteria for ampicillin-sulbactam.

Main Methods:

  • Analysis of 2,440 consecutive Enterobacteriaceae isolates across five medical centers.

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  • In vitro susceptibility testing using ampicillin-sulbactam disks of different potencies.
  • Determination of Minimum Inhibitory Concentrations (MICs) with specified sulbactam ratios and breakpoints.

    • Main Results:

    • The reliability of the disk test diminished with increased sulbactam concentration in the disks.
    • Specific disk potencies (10 µg ampicillin/10 µg sulbactam) and interpretive criteria (≥15 mm susceptible, ≤11 mm resistant) are recommended.
    • MIC breakpoints for susceptibility were defined as ≤16/8.0 µg/ml or ≤8.0/8.0 µg/ml.

    Conclusions:

    • Standardized ampicillin-sulbactam disk testing is essential for accurate Enterobacteriaceae susceptibility assessment.
    • Optimized disk potency and interpretive criteria are crucial for reliable clinical guidance.
    • Further validation is needed to confirm the reliability of disk diffusion tests with varying antibiotic concentrations.