Aminoglycoside resistance and susceptibility testing errors in Acinetobacter baumannii-calcoaceticus complex.

Journal of Clinical Microbiology
Kevin S AkersClinton K Murray

Abstract

Antimicrobial resistance is depleting the pharmacopeia of agents clinically useful against Gram-negative bacilli. As the number of active agents diminishes, accurate susceptibility testing becomes critical. We studied the susceptibilities of 107 isolates of the Acinetobacter baumannii-calcoaceticus complex to amikacin, gentamicin, and tobramycin using disk diffusion, Etest, as well as the Phoenix, Vitek 2, and MicroScan automated systems, and compared the results to those obtained by broth microdilution. Genes encoding aminoglycoside-modifying enzymes (AMEs) were detected by multiplex PCR, and clonal relationships were determined by pulsed-field gel electrophoresis. Tobramycin was the most active aminoglycoside (27.1% of isolates were susceptible). Disk diffusion and Etest tended to be more accurate than the Vitek 2, Phoenix, and MicroScan automated systems; but errors were noted with all methods. The Vitek 2 instrument incorrectly reported that more than one-third of the isolates were susceptible to amikacin (a very major error). Isolates were polyclonal, with 26 distinct strains, and carried multiple AME genes unrelated to the strain type. The presence of the ant(2")-Ia gene was statistically associated with resistance to eac...Continue Reading

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Citations

Aug 10, 2011·Antimicrobial Agents and Chemotherapy·Kevin S AkersClinton K Murray
Jan 30, 2015·Jundishapur Journal of Microbiology·Katayun AliakbarzadeAsghar Tanomand
Nov 15, 2011·Journal of Theoretical Biology·Mohammad Reza RahbarMarziyeh Jalali
Dec 25, 2012·Journal of Medical Microbiology·Agnes SonnevendTibor Pál
Jan 16, 2013·Scandinavian Journal of Infectious Diseases·Alice BarsoumianKevin S Akers
Mar 8, 2011·International Journal of Antimicrobial Agents·Jenny Cortez-Cordova, Ayush Kumar
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