Abstract
We determined the E-Test and National Committee for Clinical Laboratory Standards standardized agar dilution MICs of ceftazidime, ciprofloxacin, piperacillin, and tobramycin for Pseudomonas aeruginosa during tests of 100 rough and mucoid P. aeruginosa isolates from cystic fibrosis patients. The levels of agreement (+/- 1 log2 dilution) between quantitative E-Test and agar dilution MIC results were 80, 97, 73, and 89% for ceftazidime, ciprofloxacin, piperacillin, and tobramycin, respectively. Comparison of the results after converting the MIC data to qualitative categories (susceptible, intermediate, and resistant) yielded levels of agreement of 84, 96, 88, and 93% for the same agents, respectively. Of the 39 qualitative discrepancies, 36 were minor and 3 were very major. We conclude that use of the E-Test is easier and more practical than use of the agar dilution method for most laboratories and that the E-Test furnishes results which are at least as accurate as those obtained by the agar dilution method. However, the higher cost of the E-Test method would likely discourage most laboratories from selecting it over disk diffusion for routine antimicrobial susceptibility testing of P. aeruginosa isolates from cystic fibrosis patients.
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Selected References
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- Baker C. N., Stocker S. A., Culver D. H., Thornsberry C. Comparison of the E Test to agar dilution, broth microdilution, and agar diffusion susceptibility testing techniques by using a special challenge set of bacteria. J Clin Microbiol. 1991 Mar;29(3):533–538. doi: 10.1128/jcm.29.3.533-538.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Colombo A. L., Barchiesi F., McGough D. A., Rinaldi M. G. Comparison of Etest and National Committee for Clinical Laboratory Standards broth macrodilution method for azole antifungal susceptibility testing. J Clin Microbiol. 1995 Mar;33(3):535–540. doi: 10.1128/jcm.33.3.535-540.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Couroux P. R., Massey V. E., Schieven B. C., Lannigan R., Hussain Z. Comparison of the E-test and reference agar dilution method for susceptibility of gram-negative anaerobic organisms. Am J Clin Pathol. 1993 Sep;100(3):301–303. doi: 10.1093/ajcp/100.3.301. [DOI] [PubMed] [Google Scholar]
- Douglas C. P., Siarakas S., Gottlieb T. Evaluation of E test as a rapid method for determining MICs for nutritionally variant streptococci. J Clin Microbiol. 1994 Sep;32(9):2318–2320. doi: 10.1128/jcm.32.9.2318-2320.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- George R. H. Pseudomonas infections in cystic fibrosis. Arch Dis Child. 1987 May;62(5):438–439. doi: 10.1136/adc.62.5.438. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hoffner S. E., Klintz L., Olsson-Liljequist B., Bolmström A. Evaluation of Etest for rapid susceptibility testing of Mycobacterium chelonae and M. fortuitum. J Clin Microbiol. 1994 Aug;32(8):1846–1849. doi: 10.1128/jcm.32.8.1846-1849.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jorgensen J. H., Ferraro M. J., McElmeel M. L., Spargo J., Swenson J. M., Tenover F. C. Detection of penicillin and extended-spectrum cephalosporin resistance among Streptococcus pneumoniae clinical isolates by use of the E test. J Clin Microbiol. 1994 Jan;32(1):159–163. doi: 10.1128/jcm.32.1.159-163.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Joyce L. F., Downes J., Stockman K., Andrew J. H. Comparison of five methods, including the PDM Epsilometer test (E test), for antimicrobial susceptibility testing of Pseudomonas aeruginosa. J Clin Microbiol. 1992 Oct;30(10):2709–2713. doi: 10.1128/jcm.30.10.2709-2713.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Korvick J. A., Yu V. L. Antimicrobial agent therapy for Pseudomonas aeruginosa. Antimicrob Agents Chemother. 1991 Nov;35(11):2167–2172. doi: 10.1128/aac.35.11.2167. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Levy J. Antibiotic therapy in cystic fibrosis. Evaluation of efficacy. Chest. 1988 Aug;94(2 Suppl):150S–156S. [PubMed] [Google Scholar]
- Macias E. A., Mason E. O., Jr, Ocera H. Y., LaRocco M. T. Comparison of E test with standard broth microdilution for determining antibiotic susceptibilities of penicillin-resistant strains of Streptococcus pneumoniae. J Clin Microbiol. 1994 Feb;32(2):430–432. doi: 10.1128/jcm.32.2.430-432.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Michel B. C. Antibacterial therapy in cystic fibrosis. A review of the literature published between 1980 and February 1987. Chest. 1988 Aug;94(2 Suppl):129S–140S. doi: 10.1378/chest.94.2.129s. [DOI] [PubMed] [Google Scholar]
- O'Donnell C. R., Bader M. B., Zibrak J. D., Jensen W. A., Rose R. M. Abnormal airway function in individuals with the acquired immunodeficiency syndrome. Chest. 1988 Nov;94(5):945–948. doi: 10.1378/chest.94.5.945. [DOI] [PubMed] [Google Scholar]
- Rautelin H., Renkonen I., Renkonen O. V. Evaluation of the E test in testing susceptibility of Pseudomonas aeruginosa to tobramycin. Eur J Clin Microbiol Infect Dis. 1992 Feb;11(2):177–180. doi: 10.1007/BF01967074. [DOI] [PubMed] [Google Scholar]
- Schulz J. E., Sahm D. F. Reliability of the E test for detection of ampicillin, vancomycin, and high-level aminoglycoside resistance in Enterococcus spp. J Clin Microbiol. 1993 Dec;31(12):3336–3339. doi: 10.1128/jcm.31.12.3336-3339.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Steinkamp G., Tümmler B., Malottke R., von der Hardt H. Treatment of pseudomonas aeruginosa colonisation in cystic fibrosis. Arch Dis Child. 1989 Jul;64(7):1022–1028. doi: 10.1136/adc.64.7.1022. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Van Dyck E., Smet H., Piot P. Comparison of E test with agar dilution for antimicrobial susceptibility testing of Neisseria gonorrhoeae. J Clin Microbiol. 1994 Jun;32(6):1586–1588. doi: 10.1128/jcm.32.6.1586-1588.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wüst J., Hardegger U. Comparison of the E test and a reference agar dilution method for susceptibility testing of anaerobic bacteria. Eur J Clin Microbiol Infect Dis. 1992 Dec;11(12):1169–1173. doi: 10.1007/BF01961139. [DOI] [PubMed] [Google Scholar]