Tentative breakpoints and areas of technical uncertainty for early reading automated disc diffusion for Enterobacterales.

The Journal of Antimicrobial Chemotherapy
Stefano ManciniErik C Böttger

Abstract

Disc diffusion is a reliable, accurate and cost-efficient procedure for antimicrobial susceptibility testing (AST) but requires long (18-24 h) incubation times. Reading of disc diffusion after short incubation times (6-8 h) by automated systems is feasible but should be categorized with time-adapted breakpoints to reduce errors. This study systematically compared early readings (6 and 8 h) of disc diffusion using an automated system with that of the standard 18 h EUCAST method. Time-adapted tentative breakpoints were proposed to discriminate susceptible from resistant isolates and areas of technical uncertainty were defined to minimize the risk of errors. A total of 1106 Enterobacterales isolates with a wide variety of resistance mechanisms and resistance profiles were included. All isolates were analysed for susceptibility to amoxicillin/clavulanic acid, ceftriaxone, cefepime, meropenem, ciprofloxacin and gentamicin using the automated WASPLabTM system. Part of the collection (515 isolates) was also analysed for susceptibility to an additional 10 antibiotics. Separation between WT and non-WT populations was poorer at early incubation times than following standard incubation. Editing of rapid automated AST results after 6 and 8...Continue Reading

References

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Mar 24, 2017·The Journal of Antimicrobial Chemotherapy·Michael HombachErik C Böttger
Nov 6, 2018·The Journal of Antimicrobial Chemotherapy·David M LivermoreNeil Woodford
Jul 17, 2019·EBioMedicine·Stefano ManciniErik C Böttger

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