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- Title
Fully automated disc diffusion for rapid antibiotic susceptibility test results: a proof-of-principle study.
- Authors
Hombach, Michael; Jetter, Marion; Blöchliger, Nicolas; Kolesnik-Goldmann, Natalia; Böttger, Erik C.
- Abstract
<bold>Background: </bold>Antibiotic resistance poses a significant threat to patients suffering from infectious diseases. Early readings of antibiotic susceptibility test (AST) results could be of critical importance to ensure adequate treatment. Disc diffusion is a well-standardized, established and cost-efficient AST procedure; however, its use in the clinical laboratory is hampered by the many manual steps involved, and an incubation time of 16-18 h, which is required to achieve reliable test results.<bold>Methods: </bold>We have evaluated a fully automated system for its potential for early reading of disc diffusion diameters after 6-12 h of incubation. We assessed availability of results, methodological precision, categorical agreement and interpretation errors as compared with an 18 h standard. In total, 1028 clinical strains (291 Escherichia coli , 272 Klebsiella pneumoniae , 176 Staphylococcus aureus and 289 Staphylococcus epidermidis ) were included in this study. Disc diffusion plates were streaked, incubated and imaged using the WASPLab TM automation system.<bold>Results and conclusions: </bold>Our results demonstrate that: (i) early AST reading is possible for important pathogens; (ii) methodological precision is not hampered at early timepoints; and (iii) species-specific reading times must be selected. As inhibition zone diameters change over time and are phenotype/drug combination dependent, specific cut-offs and expert rules will be essential to ensure reliable interpretation and reporting of early susceptibility testing results.
- Subjects
ANTIBIOTICS; DISC diffusion tests (Microbiology); COMMUNICABLE diseases; ESCHERICHIA coli; KLEBSIELLA pneumoniae; PATIENTS; AUTOMATION; BACTERIAL diseases; DRUG resistance in microorganisms; ESCHERICHIA coli diseases; KLEBSIELLA; LABORATORIES; MICROBIAL sensitivity tests; STAPHYLOCOCCAL diseases; STAPHYLOCOCCUS; STAPHYLOCOCCUS aureus; KLEBSIELLA infections; PHARMACODYNAMICS; EQUIPMENT &; supplies
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2017, Vol 72, Issue 6, p1659
- ISSN
0305-7453
- Publication type
journal article
- DOI
10.1093/jac/dkx026