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Diagn Microbiol Infect Dis. 2018 May;91(1):89-92. doi: 10.1016/j.diagmicrobio.2018.01.005. Epub 2018 Jan 9.

Evaluation of Sensititre Broth Microdilution Plate for determining the susceptibility of carbapenem-resistant Klebsiella pneumoniae to polymyxins.

Author information

1
Cleveland Clinic, Cleveland, OH,. Electronic address: richtes@ccf.org.
2
Cleveland Clinic, Cleveland, OH.
3
Department of Veteran Affairs Medical Center, Cleveland, OH,; Department of Molecular Biology and Microbiology, Case Western Reserve Univ. School of Medicine, Cleveland, OH.
4
Department of Veteran Affairs Medical Center, Cleveland, OH,; Case-VA CARES, Case Western Reserve Univ., Cleveland, OH.
5
Department of Veteran Affairs Medical Center, Cleveland, OH,; Department of Medicine, Case Western Reserve Univ. School of Medicine, Cleveland, OH.
6
Department of Veteran Affairs Medical Center, Cleveland, OH.
7
Department of Veteran Affairs Medical Center, Cleveland, OH,; Case-VA CARES, Case Western Reserve Univ., Cleveland, OH,; Department of Medicine, Case Western Reserve Univ. School of Medicine, Cleveland, OH.
8
Univ. of Michigan, Ann Arbor, MI.
9
Case-VA CARES, Case Western Reserve Univ., Cleveland, OH.
10
Univ. of North Carolina, Chapel Hill, NC.
11
Department of Veteran Affairs Medical Center, Cleveland, OH,; Case-VA CARES, Case Western Reserve Univ., Cleveland, OH,; Department of Medicine, Case Western Reserve Univ. School of Medicine, Cleveland, OH; Department of Molecular Biology and Microbiology, Case Western Reserve Univ. School of Medicine, Cleveland, OH; Department of Biochemistry, Case Western Reserve Univ. School of Medicine, Cleveland, OH; Department of Pharmacology, Case Western Reserve Univ. School of Medicine, Cleveland, OH; Department of Proteomics and Bioinformatics, Case Western Reserve Univ. School of Medicine, Cleveland, OH.

Abstract

Colistin and polymyxin B MICs were determined for 106 carbapenem-resistant Klebsiella pneumoniae (CR-Kp) isolates using Sensititre Research Use Only GNX2F plates (Thermo Fisher) and compared to CLSI broth macrodilution (BMD) as the reference method. For colistin, EUCAST breakpoints were applied and testing of isolates with very major (VM) errors was repeated in duplicate by both methods to determine a majority result. Essential agreement (MIC ± one dilution) of GNX2F with the reference method was 97.1% for polymyxin B and 92.5% for colistin (7 VM errors, 22.6%). After discrepancy testing, there were 28 colistin resistant isolates by BMD and essential agreement was 94.3% with 4 VM errors (14.3%). Colistin and polymyxin B GNX2F results showed acceptable essential agreement with BMD for MICS without interpretation. Colistin VM errors with EUCAST breakpoints were due to MIC variability in the 2 to 4 μg/mL range that could be addressed by establishing an intermediate category.

KEYWORDS:

Colistin; carbapenem-resistant Enterobacteriaceae; polymyxin

PMID:
29456071
PMCID:
PMC6083442
[Available on 2019-05-01]
DOI:
10.1016/j.diagmicrobio.2018.01.005
[Indexed for MEDLINE]

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