Performance of modified colistin broth disc elution vis-a-vis broth microdilution method for susceptibility testing of Enterobacterales

Pub Date : 2024-05-06 DOI:10.25259/jlp-2023-5-25-(1801)
P. Kar, A. Mahapatra, Bilal Ahmad Malik, B. Behera, Srujana Mohanty
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Abstract

Recently, Clinical and Laboratory Standards Institute (CLSI) has approved colistin broth disc elution (CBDE) to be a supplemental test. This requires multiple discs and tubes to get the desired concentrations of colistin -1, 2, and 4 µg/mL and 10 mL volume of cation-adjusted Mueller–Hinton broth for a single isolate. The present study was aimed to evaluate the performance of CBDE in a microtiter plate format modified (mCBDE) with the reference method broth microdilution (BMD) for detection of colistin resistance in carbapenem-resistant Enterobacterales (CRE) isolates. One hundred and sixty non-duplicate clinical CRE isolates (May 2021–April 2022) were simultaneously subjected for BMD and mCBDE. For mCBDE, colistin 10 µg discs and Mueller–Hinton broth no-2 control cations were procured from HiMedia, Mumbai, and drug concentrations were prepared following CLSI-M100Ed31. Results of mCBDE were compared with reference BMD (Minimum inhibitory concentration [MIC] ≤2 µg/mL – intermediate and ≥4 µg/mL – resistant). The performance of mCBDE was compared with BMD and expressed in terms of Categorical, essential agreement (EA), very major error (VME), and major error (ME). The sensitivity and specificity were calculated using Fisher’s contingency Table. Of the 160 CRE isolates, 152 had exactly the same minimal inhibitory concentration (MIC) in both the tests with four isolates having higher and four having lower colistin MIC by mCBDE, giving a major error of 2.1% and VME of 5.5%. Categorical and essential agreement of mCBDE were 97.5% and 98.7%, respectively. mCBDE is an easy, economical, and reliable alternative test for determining colistin susceptibility for CRE isolates. Further, large-scale study is needed to strengthen our observation.
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改良的可乐定肉汤圆盘洗脱法与肉汤微量稀释法在肠杆菌药敏试验中的性能比较
最近,临床与实验室标准协会(CLSI)批准将秋水仙素肉汤洗脱(CBDE)作为一项补充检测。对于单个分离物来说,这需要多个圆盘和试管以及 10 毫升阳离子调整的穆勒-欣顿肉汤来获得所需的浓度-1、2 和 4 微克/毫升的秋水仙素。本研究旨在评估改良微孔板格式的 CBDE(mCBDE)与肉汤微量稀释法(BMD)在检测耐碳青霉烯类肠杆菌(CRE)分离物的可乐定耐药性方面的性能。对于 mCBDE,从孟买 HiMedia 公司购买了可乐定 10 µg 盘和 Mueller-Hinton 肉汤 No-2 对照阳离子,并按照 CLSI-M100Ed31 配制了药物浓度。mCBDE 的结果与参考 BMD(最低抑菌浓度 [MIC] ≤2 µg/mL - 中度和 ≥4 µg/mL - 耐药)进行了比较。mCBDE 的性能与 BMD 进行了比较,用分类、基本一致 (EA)、非常大误差 (VME) 和大误差 (ME) 表示。在 160 个 CRE 分离物中,有 152 个在两种测试中的最小抑菌浓度 (MIC) 完全相同,其中 4 个分离物的 mCBDE MIC 较高,4 个较低,主要误差为 2.1%,VME 为 5.5%。mCBDE 是确定 CRE 分离物对可乐定敏感性的一种简便、经济、可靠的替代检测方法。我们需要进一步开展大规模研究,以加强我们的观察结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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