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. 1994 Jan;32(1):159–163. doi: 10.1128/jcm.32.1.159-163.1994

Detection of penicillin and extended-spectrum cephalosporin resistance among Streptococcus pneumoniae clinical isolates by use of the E test.

J H Jorgensen 1, M J Ferraro 1, M L McElmeel 1, J Spargo 1, J M Swenson 1, F C Tenover 1
PMCID: PMC262988  PMID: 8126173

Abstract

Increasing penicillin resistance and the initial recognition of resistance to extended-spectrum cephalosporins among Streptococcus pneumoniae isolates have placed greater emphasis on accurate methods for susceptibility testing of clinical isolates. This study has evaluated the use of the E test (AB Biodisk NA, Piscataway, N.J.) for the detection of penicillin and cefotaxime resistance among 147 pneumococcal clinical isolates in three geographically separate laboratories. These included 42 penicillin-resistant (MIC, > or = 2 micrograms/ml) and 14 cefotaxime-resistant (defined here as an MIC of > or = 2 micrograms/ml) isolates. E test strips were applied to the surface of Mueller-Hinton sheep blood agar plates and incubated at 35 degrees C in 5% CO2 for 20 to 24 h. E test MICs were compared with MICs determined with lysed horse blood-supplemented Mueller-Hinton broth in a microdilution format as recommended by the National Committee for Clinical Laboratory Standards. Penicillin MICs agreed within one log2 dilution for 136 of 147 (92.5%) isolates, and cefotaxime MICs agreed within one log2 dilution for 142 of 147 (96.6%) isolates. No very major or major interpretive errors occurred with either penicillin or cefotaxime E test MIC results. There were 9.5 and 5.4% minor interpretive category errors with penicillin and cefotaxime E test MICs, respectively. These data indicate that the E test represents a convenient and reliable method for the detection of penicillin or cephalosporin resistance in pneumococci.

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Selected References

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  1. 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]
  2. Bradley J. S., Connor J. D. Ceftriaxone failure in meningitis caused by Streptococcus pneumoniae with reduced susceptibility to beta-lactam antibiotics. Pediatr Infect Dis J. 1991 Nov;10(11):871–873. [PubMed] [Google Scholar]
  3. Citron D. M., Ostovari M. I., Karlsson A., Goldstein E. J. Evaluation of the E test for susceptibility testing of anaerobic bacteria. J Clin Microbiol. 1991 Oct;29(10):2197–2203. doi: 10.1128/jcm.29.10.2197-2203.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Friedland I. R., Shelton S., McCracken G. H., Jr Screening for cephalosporin-resistant Streptococcus pneumoniae with the Kirby-Bauer disk susceptibility test. J Clin Microbiol. 1993 Jun;31(6):1619–1621. doi: 10.1128/jcm.31.6.1619-1621.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Friedland I. R., Shelton S., Paris M., Rinderknecht S., Ehrett S., Krisher K., McCracken G. H., Jr Dilemmas in diagnosis and management of cephalosporin-resistant Streptococcus pneumoniae meningitis. Pediatr Infect Dis J. 1993 Mar;12(3):196–200. doi: 10.1097/00006454-199303000-00004. [DOI] [PubMed] [Google Scholar]
  6. Jorgensen J. H., Doern G. V., Ferraro M. J., Knapp C. C., Swenson J. M., Washington J. A. Multicenter evaluation of the use of Haemophilus test medium for broth microdilution antimicrobial susceptibility testing of Streptococcus pneumoniae and development of quality control limits. J Clin Microbiol. 1992 Apr;30(4):961–966. doi: 10.1128/jcm.30.4.961-966.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Jorgensen J. H., Doern G. V., Maher L. A., Howell A. W., Redding J. S. Antimicrobial resistance among respiratory isolates of Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae in the United States. Antimicrob Agents Chemother. 1990 Nov;34(11):2075–2080. doi: 10.1128/aac.34.11.2075. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Jorgensen J. H., Howell A. W., Maher L. A. Quantitative antimicrobial susceptibility testing of Haemophilus influenzae and Streptococcus pneumoniae by using the E-test. J Clin Microbiol. 1991 Jan;29(1):109–114. doi: 10.1128/jcm.29.1.109-114.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Klass P. E., Klein J. O. Therapy of bacterial sepsis, meningitis and otitis media in infants and children: 1992 poll of directors of programs in pediatric infectious diseases. Pediatr Infect Dis J. 1992 Sep;11(9):702–705. doi: 10.1097/00006454-199209000-00005. [DOI] [PubMed] [Google Scholar]
  10. Klugman K. P. Pneumococcal resistance to antibiotics. Clin Microbiol Rev. 1990 Apr;3(2):171–196. doi: 10.1128/cmr.3.2.171. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Mason E. O., Jr, Kaplan S. L., Lamberth L. B., Tillman J. Increased rate of isolation of penicillin-resistant Streptococcus pneumoniae in a children's hospital and in vitro susceptibilities to antibiotics of potential therapeutic use. Antimicrob Agents Chemother. 1992 Aug;36(8):1703–1707. doi: 10.1128/aac.36.8.1703. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. McDougal L. K., Facklam R., Reeves M., Hunter S., Swenson J. M., Hill B. C., Tenover F. C. Analysis of multiply antimicrobial-resistant isolates of Streptococcus pneumoniae from the United States. Antimicrob Agents Chemother. 1992 Oct;36(10):2176–2184. doi: 10.1128/aac.36.10.2176. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Muñoz R., Coffey T. J., Daniels M., Dowson C. G., Laible G., Casal J., Hakenbeck R., Jacobs M., Musser J. M., Spratt B. G. Intercontinental spread of a multiresistant clone of serotype 23F Streptococcus pneumoniae. J Infect Dis. 1991 Aug;164(2):302–306. doi: 10.1093/infdis/164.2.302. [DOI] [PubMed] [Google Scholar]
  14. O'Keeffe P. T., Bayston R. Pneumococcal meningitis in a child with a ventriculo-peritoneal shunt. J Infect. 1991 Jan;22(1):77–79. doi: 10.1016/0163-4453(91)91066-7. [DOI] [PubMed] [Google Scholar]
  15. Pallares R., Gudiol F., Liñares J., Ariza J., Rufi G., Murgui L., Dorca J., Viladrich P. F. Risk factors and response to antibiotic therapy in adults with bacteremic pneumonia caused by penicillin-resistant pneumococci. N Engl J Med. 1987 Jul 2;317(1):18–22. doi: 10.1056/NEJM198707023170104. [DOI] [PubMed] [Google Scholar]
  16. Reichler M. R., Allphin A. A., Breiman R. F., Schreiber J. R., Arnold J. E., McDougal L. K., Facklam R. R., Boxerbaum B., May D., Walton R. O. The spread of multiply resistant Streptococcus pneumoniae at a day care center in Ohio. J Infect Dis. 1992 Dec;166(6):1346–1353. doi: 10.1093/infdis/166.6.1346. [DOI] [PubMed] [Google Scholar]
  17. Sloas M. M., Barrett F. F., Chesney P. J., English B. K., Hill B. C., Tenover F. C., Leggiadro R. J. Cephalosporin treatment failure in penicillin- and cephalosporin-resistant Streptococcus pneumoniae meningitis. Pediatr Infect Dis J. 1992 Aug;11(8):662–666. [PubMed] [Google Scholar]
  18. Spika J. S., Facklam R. R., Plikaytis B. D., Oxtoby M. J. Antimicrobial resistance of Streptococcus pneumoniae in the United States, 1979-1987. The Pneumococcal Surveillance Working Group. J Infect Dis. 1991 Jun;163(6):1273–1278. doi: 10.1093/infdis/163.6.1273. [DOI] [PubMed] [Google Scholar]
  19. Swenson J. M., Hill B. C., Thornsberry C. Screening pneumococci for penicillin resistance. J Clin Microbiol. 1986 Nov;24(5):749–752. doi: 10.1128/jcm.24.5.749-752.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Tenover F. C., Swenson J. M., McDougal L. K. Screening for extended-spectrum cephalosporin resistance in pneumococci. Lancet. 1992 Dec 5;340(8832):1420–1420. doi: 10.1016/0140-6736(92)92617-o. [DOI] [PubMed] [Google Scholar]
  21. Viladrich P. F., Gudiol F., Liñares J., Rufi G., Ariza J., Pallares R. Characteristics and antibiotic therapy of adult meningitis due to penicillin-resistant pneumococci. Am J Med. 1988 May;84(5):839–846. doi: 10.1016/0002-9343(88)90061-7. [DOI] [PubMed] [Google Scholar]
  22. Weingarten R. D., Markiewicz Z., Gilbert D. N. Meningitis due to penicillin-resistant Streptococcus pneumoniae in adults. Rev Infect Dis. 1990 Jan-Feb;12(1):118–124. doi: 10.1093/clinids/12.1.118. [DOI] [PubMed] [Google Scholar]
  23. Willett L. D., Dillon H. C., Jr, Gray B. M. Penicillin-intermediate pneumococci in a children's hospital. Am J Dis Child. 1985 Oct;139(10):1054–1057. doi: 10.1001/archpedi.1985.02140120100037. [DOI] [PubMed] [Google Scholar]

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