Skip to main content
PMC home page
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1997 Jul;35(7):1842–1846. doi: 10.1128/jcm.35.7.1842-1846.1997

Comparative evaluation of the E test, agar dilution, and broth microdilution for testing susceptibilities of Helicobacter pylori strains to 20 antimicrobial agents.

R Piccolomini 1, G Di Bonaventura 1, G Catamo 1, F Carbone 1, M Neri 1
PMCID: PMC229853  PMID: 9196205

Abstract

The Epsilometer test (E test; AB Biodisk, Solna, Sweden), a new quantitative technique for the determination of antimicrobial susceptibility, was compared to reference methods (agar dilution and broth microdilution) for the antimicrobial susceptibility testing of Helicobacter pylori. Seventy-one H. pylori strains isolated from patients with duodenal ulcers were tested against 20 antimicrobial agents. The E test and the agar dilution method were carried out on Mueller-Hinton agar; the broth microdilution method was performed with Mueller-Hinton broth. The E-test results showed excellent correlation with the agar dilution results, with 91.3 and 98.8% agreement within 1 and 2 log2 dilution steps, respectively, in a total of 1,350 tests. The correlation between the E-test results and the broth microdilution results was slightly higher, with 91.6 and 99.1% agreement within 1 and 2 log2 dilution steps, respectively, in a total of 1,317 tests. There were six major errors and two very major errors by the metronidazole E test compared to the results obtained by reference methods. Excellent agreement between E-test, agar dilution, and broth microdilution results was found for resistance to erythromycin (8%), clarithromycin (6%), and tetracycline (6%). Our results confirm that the E test is comparable to standardized methods for susceptibility testing. Therefore, the E test is a reliable and alternative method for testing H. pylori susceptibility to a wide range of antimicrobial agents in clinical practice.

Full Text

The Full Text of this article is available as a PDF (128.7 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Axon A. T. Helicobacter pylori therapy: effect on peptic ulcer disease. J Gastroenterol Hepatol. 1991 Mar-Apr;6(2):131–137. doi: 10.1111/j.1440-1746.1991.tb01452.x. [DOI] [PubMed] [Google Scholar]
  2. 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]
  3. Becx M. C., Janssen A. J., Clasener H. A., de Koning R. W. Metronidazole-resistant Helicobacter pylori. Lancet. 1990 Mar 3;335(8688):539–540. doi: 10.1016/0140-6736(90)90772-w. [DOI] [PubMed] [Google Scholar]
  4. Brown D. F., Brown L. Evaluation of the E test, a novel method of quantifying antimicrobial activity. J Antimicrob Chemother. 1991 Feb;27(2):185–190. doi: 10.1093/jac/27.2.185. [DOI] [PubMed] [Google Scholar]
  5. Cederbrant G., Kahlmeter G., Ljungh A. The E test for antimicrobial susceptibility testing of Helicobacter pylori. J Antimicrob Chemother. 1993 Jan;31(1):65–71. doi: 10.1093/jac/31.1.65. [DOI] [PubMed] [Google Scholar]
  6. Colombo A. L., Barchiesi F., McGough D. A., Fothergill A. W., Rinaldi M. G. Evaluation of the E test system versus a microtitre broth method for antifungal susceptibility testing of yeasts against fluconazole and itraconazole. J Antimicrob Chemother. 1995 Jul;36(1):93–100. doi: 10.1093/jac/36.1.93. [DOI] [PubMed] [Google Scholar]
  7. Dooley C. P., Cohen H. The clinical significance of Campylobacter pylori. Ann Intern Med. 1988 Jan;108(1):70–79. doi: 10.7326/0003-4819-108-1-70. [DOI] [PubMed] [Google Scholar]
  8. Glupczynski Y., Delmee M., Bruck C., Labbe M., Avesani V., Burette A. Susceptibility of clinical isolates of Campylobacter pylori to 24 antimicrobial and anti-ulcer agents. Eur J Epidemiol. 1988 Jun;4(2):154–157. doi: 10.1007/BF00144743. [DOI] [PubMed] [Google Scholar]
  9. Glupczynski Y., Labbé M., Hansen W., Crokaert F., Yourassowsky E. Evaluation of the E test for quantitative antimicrobial susceptibility testing of Helicobacter pylori. J Clin Microbiol. 1991 Sep;29(9):2072–2075. doi: 10.1128/jcm.29.9.2072-2075.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Goodwin C. S., Armstrong J. A., Marshall B. J. Campylobacter pyloridis, gastritis, and peptic ulceration. J Clin Pathol. 1986 Apr;39(4):353–365. doi: 10.1136/jcp.39.4.353. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Goodwin C. S., Blake P., Blincow E. The minimum inhibitory and bactericidal concentrations of antibiotics and anti-ulcer agents against Campylobacter pyloridis. J Antimicrob Chemother. 1986 Mar;17(3):309–314. doi: 10.1093/jac/17.3.309. [DOI] [PubMed] [Google Scholar]
  12. Graham D. Y. Campylobacter pylori and peptic ulcer disease. Gastroenterology. 1989 Feb;96(2 Pt 2 Suppl):615–625. doi: 10.1016/s0016-5085(89)80057-5. [DOI] [PubMed] [Google Scholar]
  13. Jorgensen J. H. Selection criteria for an antimicrobial susceptibility testing system. J Clin Microbiol. 1993 Nov;31(11):2841–2844. doi: 10.1128/jcm.31.11.2841-2844.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Lambert T., Mégraud F., Gerbaud G., Courvalin P. Susceptibility of Campylobacter pyloridis to 20 antimicrobial agents. Antimicrob Agents Chemother. 1986 Sep;30(3):510–511. doi: 10.1128/aac.30.3.510. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. McNulty C. A., Dent J., Wise R. Susceptibility of clinical isolates of Campylobacter pyloridis to 11 antimicrobial agents. Antimicrob Agents Chemother. 1985 Dec;28(6):837–838. doi: 10.1128/aac.28.6.837. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Murray P. R., Niles A. C., Heeren R. L. Comparison of a highly automated 5-h susceptibility testing system, the Cobas-Bact, with two reference methods: Kirby-Bauer disk diffusion and broth microdilution. J Clin Microbiol. 1987 Dec;25(12):2372–2377. doi: 10.1128/jcm.25.12.2372-2377.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Rautelin H., Seppälä K., Renkonen O. V., Vainio U., Kosunen T. U. Role of metronidazole resistance in therapy of Helicobacter pylori infections. Antimicrob Agents Chemother. 1992 Jan;36(1):163–166. doi: 10.1128/aac.36.1.163. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Sewell D. L., Pfaller M. A., Barry A. L. Comparison of broth macrodilution, broth microdilution, and E test antifungal susceptibility tests for fluconazole. J Clin Microbiol. 1994 Sep;32(9):2099–2102. doi: 10.1128/jcm.32.9.2099-2102.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Shahamat M., Paszko-Kolva C., Mai U. E., Yamamoto H., Colwell R. R. Selected cryopreservatives for long term storage of Helicobacter pylori at low temperatures. J Clin Pathol. 1992 Aug;45(8):735–736. doi: 10.1136/jcp.45.8.735. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. van Klingeren B., Stobberingh E. E., MacLaren D. M., Schmitz P. I., Murmans M., Smeets T., Dessens M. A multicenter survey of resistance in The Netherlands using the Etest. Diagn Microbiol Infect Dis. 1994 Jul;19(3):151–156. doi: 10.1016/0732-8893(94)90058-2. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES