1887

Abstract

is a sexually transmitted bacterial pathogen that continues to evolve to become resistant to known antibiotics. In preparing for potential emergence, the Centers for Disease Control and Prevention recommends that clinical laboratories maintain or develop protocols to assess antibiotic susceptibly for this organism. This study examines the intra-laboratory variability of using the Etest method to provide consistent MIC values for and also compared the results of the Etest to known agar dilution MIC values.

Clinical isolates, 100 paired duplicates, were tested by eight laboratories for antibiotic susceptibility to ceftriaxone, cefixime and azithromycin using Etest strips.

Overall, >80 % of the paired Etest MIC values were within one log dilution of the replicate. When compared to the agar dilution reference method, the cefixime Etest MIC values were consistently underreported by one dilution (seven laboratories) or two dilutions (one laboratory). The azithromycin Etest MIC values agreed 90.7 % with the agar dilution MIC values while the agreement with ceftriaxone was 90.9 %.

Overall, the Etest method yielded reproducible MIC values within each laboratory with the azithromycin and ceftriaxone MIC results consistent to the reference agar dilution method while the cefixime result tended to provide a lower MIC value.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.000651
2018-01-01
2024-12-08
Loading full text...

Full text loading...

/deliver/fulltext/jmm/67/1/68.html?itemId=/content/journal/jmm/10.1099/jmm.0.000651&mimeType=html&fmt=ahah

References

  1. Centers for Disease Control and Prevention Sexually Transmitted Disease Surveillance Atlanta: U.S. Department of Health and Human Services; 2015 www.cdc.gov/std/stats15/gonorrhea.htm cited 2016 June 22
    [Google Scholar]
  2. Hook EW III, Hunter HH. Gonoccocal infections in the adult. In Holmes KK, Sparling FF, Stamm WE, Piot P, Wasserheit J et al. (editors) Sexually Transmitted Diseases, 4th ed. New York: McGraw-Hill Companies Inc.; 2007 pp. 627–645
    [Google Scholar]
  3. Unemo M, Nicholas RA. Emergence of multidrug-resistant, extensively drug-resistant and untreatable gonorrhea. Future Microbiol 2012; 7:1401–1422 [View Article][PubMed]
    [Google Scholar]
  4. Centers for Disease Control and Prevention 2015; Sexually transmitted diseases treatment guidelines. www.cdc.gov/std/tg2015 [cited 2016 June 22]
  5. Centers for Disease Control and Prevention Agar dilution antimicrobial susceptibility testing. www.cdc.gov/std/gonorrhea/lab/agar.htm [cited 2016 June 22]
  6. Unemo M, Golparian D, Syversen G, Vestrheim DF, Moi H. Two cases of verified clinical failures using internationally recommended first-line cefixime for gonorrhoea treatment, Norway, 2010. Eurosurv 2010; 15:19721
    [Google Scholar]
  7. Ison CA, Hussey J, Sankar KN, Evans J, Alexander S. Gonorrhea treatment failures to cefixime and azithromycin in England, 2010. Eurosurv 2011; 16:19833
    [Google Scholar]
  8. Ohnishi M, Golparian D, Shimuta K, Saika T, Hoshina S et al. Is Neisseria gonorrhoeae initiating a future era of untreatable gonorrhea?: detailed characterization of the first strain with high-level resistance to ceftriaxone. Antimicrob Agents Chemother 2011; 55:3538–3545 [View Article][PubMed]
    [Google Scholar]
  9. Unemo M, Golparian D, Stary A, Eigentler A. First Neisseria gonorrhoeae strain with resistance to cefixime causing gonorrhoea treatment failure in Austria, 2011. Euro Surveill 2011; 16:19998[PubMed]
    [Google Scholar]
  10. Unemo M, Golparian D, Nicholas R, Ohnishi M, Gallay A et al. High-level cefixime- and ceftriaxone-resistant Neisseria gonorrhoeae in France: novel penA mosaic allele in a successful international clone causes treatment failure. Antimicrob Agents Chemother 2012; 56:1273–1280 [View Article][PubMed]
    [Google Scholar]
  11. Whiley DM, Trembizki E, Buckley C, Freeman K, Baird RW et al. Molecular antimicrobial resistance surveillance for Neisseria gonorrhoeae, Northern Territory, Australia. Emerg Infect Dis 2017; 23:1478–1485 [View Article][PubMed]
    [Google Scholar]
  12. Trembizki E, Buckley C, Donovan B, Chen M, Guy R et al. Direct real-time PCR-based detection of Neisseria gonorrhoeae 23S rRNA mutations associated with azithromycin resistance. J Antimicrob Chemother 2015; 70:3244–3249 [View Article][PubMed]
    [Google Scholar]
  13. Centers for Disease Control and Prevention Laboratory testing methods for sexually transmitted diseases in public health laboratories – 2007 Summary report Atlanta: U.S. Department of Health and Human Services; www.cdc.gov/std/general/labsurveyreport-2011.pdf cited 2016 June 22
    [Google Scholar]
  14. Clinical and Laboratory Standards Institute Performance Standards for Antimicrobial Susceptibility Testing 24th informational supplement Approved standard M100-S24 Wayne, PA: Clinical and Laboratory Standards Institute; 2014
    [Google Scholar]
  15. Knapp JS. Laboratory methods for the detection and phenotypic characterization of Neisseria gonorrhoeae strains resistant to antimicrobial agents. Sex Transm Dis 1988; 15:225–233 [View Article][PubMed]
    [Google Scholar]
  16. Yasin RM, Suan KA, Meng CY. Comparison of E-test with agar dilution methods in testing susceptibility of N. gonorrhoeae to azithromycin. Sex Transm Dis 1997; 24:257–260 [View Article][PubMed]
    [Google Scholar]
  17. Liao CH, Lai CC, Hsu MS, Chu FY, Wu MY et al. Antimicrobial susceptibility of Neisseria gonorrhoeae isolates determined by the agar dilution, disk diffusion and Etest methods: comparison of results using GC agar and chocolate agar. Int J Antimicrob Agents 2010; 35:457–460 [View Article][PubMed]
    [Google Scholar]
  18. Singh V, Bala M, Kakran M, Ramesh V. Comparative assessment of CDS, CLSI disc diffusion and Etest techniques for antimicrobial susceptibility testing of Neisseria gonorrhoeae: a 6-year study. BMJ Open 2012; 2:e000969 [View Article][PubMed]
    [Google Scholar]
  19. van Dyck E, Smet H, Piot P. Comparison of E test with agar dilution for antimicrobial susceptibility testing of Neisseria gonorrhoeae . J Clin Microbiol 1994; 32:1586–1588[PubMed]
    [Google Scholar]
  20. Biedenbach DJ, Jones RN. Comparative assessment of Etest for testing susceptibilities of Neisseria gonorrhoeae to penicillin, tetracycline, ceftriaxone, cefotaxime, and ciprofloxacin: investigation using 510(k) review criteria, recommended by the Food and Drug Administration. J Clin Microbiol 1996; 34:3214–3217[PubMed]
    [Google Scholar]
  21. Gose S, Kong CJ, Lee Y, Samuel MC, Bauer HM et al. Comparison of Neisseria gonorrhoeae MICs obtained by Etest and agar dilution for ceftriaxone, cefpodoxime, cefixime and azithromycin. J Microbiol Methods 2013; 95:379–380 [View Article][PubMed]
    [Google Scholar]
  22. Shende T, Sood S, Singh R, Kapil A, Kar HK et al. Comparison of E test and agar dilution for testing activity of ceftriaxone against Neisseria gonorrhoeae . J Med Microbiol 2016; 65:701–702 [View Article][PubMed]
    [Google Scholar]
  23. Liu H, Taylor TH, Pettus K, Trees D. Assessment of value of E-test as an alternative to agar dilution for Neisseria gonorrhoeae antimicrobial susceptibility testing. J Clin Microbiol 2014; 52:1435–1340
    [Google Scholar]
  24. European Centre for Disease Prevention and Control Gonococcal Antimicrobial Susceptibility Surveillance in Europe, 2012 Stockholm: EDCD; 2012 https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/gonococcal-antimicrobial-susceptibility-surveillance-Europe-2012.pdf [cited 2016 June 22]
    [Google Scholar]
/content/journal/jmm/10.1099/jmm.0.000651
Loading
/content/journal/jmm/10.1099/jmm.0.000651
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error