Rapid detection of ESBL, carbapenemases, MRSA and other important resistance phenotypes within 6-8 h by automated disc diffusion antibiotic susceptibility testing
| Autor: | Marion Jetter, Natalia Kolesnik-Goldmann, Erik C. Böttger, Nicolas Blöchliger, Michael Hombach, Peter M. Keller |
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| Přispěvatelé: | University of Zurich, Hombach, Michael |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Methicillin-Resistant Staphylococcus aureus Staphylococcus aureus Time Factors Klebsiella pneumoniae medicine.drug_class Staphylococcus 030106 microbiology Antibiotics 610 Medicine & health Microbial Sensitivity Tests medicine.disease_cause beta-Lactamases 2726 Microbiology (medical) Incubation period Microbiology 03 medical and health sciences Bacterial Proteins Enterobacteriaceae Staphylococcus epidermidis Enterobacter cloacae medicine Escherichia coli Humans 2736 Pharmacology (medical) Pharmacology (medical) Escherichia coli Infections Pharmacology Automation Laboratory biology 10179 Institute of Medical Microbiology Enterobacteriaceae Infections 2725 Infectious Diseases Staphylococcal Infections biology.organism_classification Anti-Bacterial Agents Infectious Diseases Phenotype 3004 Pharmacology 570 Life sciences |
| DOI: | 10.5167/uzh-141752 |
| Popis: | Background In principle, automated systems allow rapid reading of disc diffusion AST (rAST) within 6-8 h. Objectives This study analysed whether rAST can discriminate resistance phenotypes such as ESBL, carbapenemases and MRSA/methicillin-resistant Staphylococcus epidermidis from WT populations. We describe species-drug combinations that may require clinical breakpoint adaptions for early reading due to zone diameter changes during the incubation period. Methods In total, 1852 clinical strains [Escherichia coli (n = 475), Klebsiella pneumoniae (n = 375), Enterobacter cloacae (n = 301), Staphylococcus aureus (n = 407) and S. epidermidis (n = 294)] were included in this study comprising WT populations and important resistance phenotypes, e.g. ESBL, carbapenemases and MRSA. We assessed (i) separation of resistance phenotypes and WT populations after 6, 8 and 12 h as compared with the 18 h standard, and (ii) diameter changes of WT populations and associated putative epidemiological cut-offs during the incubation period. Disc diffusion plates were automatically streaked, incubated and imaged using the WASPLabTM system. Results and conclusions We demonstrated that important resistance phenotypes could reliably be separated from WT populations at early reading times for the most prevalent bacterial pathogens encountered in the clinical laboratory. Current AST expert rules and algorithms for identification of resistance mechanisms can readily be applied for rAST, e.g. EUCAST recommended rules for detection of ESBL, AmpC, carbapenemases and MRSA/methicillin-resistant S. epidermidis. However, several species-drug combinations may require clinical breakpoint adaptations when using rAST as the diameter, and hence the epidemiological cut-off, changes during the incubation period. |
| Databáze: | OpenAIRE |
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