1887

Abstract

Purpose. Despite being in clinical use for decades, colistin susceptibility testing remains challenging because of its inherent cationic properties. We aimed to compare the performance characteristics of different methods for testing susceptibility to colistin in a series of clinical isolates of Gram-negative bacilli.

Methodology. One hundred and nine clinical isolates of Klebsiella pneumoniae (n=34), Escherichia coli (n=20), Acinetobacter baumannii (n=17) and Pseudomonas aeruginosa (n=38) were studied for colistin susceptibility using broth microdilution (BMID), broth macrodilution (BMAD), agar dilution (AD) as well as disc-diffusion (DD) utilizing two different commercial disc sources.

Results. By using BMID as reference method, 88 and 21 isolates were found to be colistin susceptible and resistant, respectively. Overall, acceptable essential agreement (EA) and categorical agreement (CA) were observed between BMAD and reference method (100 %). Whereas the AD method revealed the lowest rate of EA (61.7, 11.7, 5.0 and 5.2 % for K. pneumoniae, A. baumannii, E. coli and P. aeruginosa, respectively), it showed acceptable or near acceptable CA for K. pneumoniae (100 %), E. coli (100 %) and A. baumannii (88.2 %) isolates but not for P. aeruginosa (13.1 %). DD failed to detect resistance in colistin-resistant (colR) P. aeruginosa (n=5, very major errors of 100 %) but successfully identified all high-level colistin-resistant A. baumannii and K. pneumoniae isolates.

Conclusion. We found BMAD to be very reliable for colistin MIC determination. Methods AD and DD should not be used for colistin susceptibility testing in P. aeruginosa isolates as these are associated with false-resistant and -susceptible results, respectively.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.000879
2018-12-05
2024-12-08
Loading full text...

Full text loading...

/deliver/fulltext/jmm/68/1/60.html?itemId=/content/journal/jmm/10.1099/jmm.0.000879&mimeType=html&fmt=ahah

References

  1. Li J, Nation RL, Turnidge JD, Milne RW, Coulthard K et al. Colistin: the re-emerging antibiotic for multidrug-resistant gram-negative bacterial infections. Lancet Infect Dis 2006; 6:589–601 [View Article][PubMed]
    [Google Scholar]
  2. Olaitan AO, Morand S, Rolain JM. Mechanisms of polymyxin resistance: acquired and intrinsic resistance in bacteria. Front Microbiol 2014; 5: [View Article][PubMed]
    [Google Scholar]
  3. Gupta S, Govil D, Kakar PN, Prakash O, Arora D et al. Colistin and polymyxin B: a re-emergence. Indian J Crit Care Med 2009; 13:49 [View Article][PubMed]
    [Google Scholar]
  4. Deris ZZ, Swarbrick JD, Roberts KD, Azad MA, Akter J et al. Probing the penetration of antimicrobial polymyxin lipopeptides into gram-negative bacteria. Bioconjug Chem 2014; 25:750–760 [View Article][PubMed]
    [Google Scholar]
  5. Liu YY, Wang Y, Walsh TR, Yi LX, Zhang R et al. Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: a microbiological and molecular biological study. Lancet Infect Dis 2016; 16:161–168 [View Article][PubMed]
    [Google Scholar]
  6. Xavier BB, Lammens C, Ruhal R, Kumar-Singh S, Butaye P et al. Identification of a novel plasmid-mediated colistin-resistance gene, mcr-2, in Escherichia coli, Belgium, June 2016. Eurosurveillance 2016; 21: [View Article][PubMed]
    [Google Scholar]
  7. Yin W, Li H, Shen Y, Liu Z, Wang S et al. Novel plasmid-mediated colistin resistance gene mcr-3 in Escherichia coli. MBio 2017; 8:e0054300517 [View Article][PubMed]
    [Google Scholar]
  8. Carattoli A, Villa L, Feudi C, Curcio L, Orsini S et al. Novel plasmid-mediated colistin resistance mcr-4 gene in Salmonella and Escherichia coli, Italy 2013, Spain and Belgium, 2015 to 2016. Euro Surveill 2017; 22: [View Article][PubMed]
    [Google Scholar]
  9. Borowiak M, Fischer J, Hammerl JA, Hendriksen RS, Szabo I et al. Identification of a novel transposon-associated phosphoethanolamine transferase gene, mcr-5, conferring colistin resistance in d-tartrate fermenting Salmonella enterica subsp. enterica serovar Paratyphi B. J Antimicrob Chemother 2017; 72:3317–3324 [View Article][PubMed]
    [Google Scholar]
  10. Vasoo S. Susceptibility testing for the polymyxins: two steps back, three steps forward?. J Clin Microbiol 2017; 55:2573–2582 [View Article][PubMed]
    [Google Scholar]
  11. Galani I, Kontopidou F, Souli M, Rekatsina PD, Koratzanis E et al. Colistin susceptibility testing by Etest and disk diffusion methods. Int J Antimicrob Agents 2008; 31:434–439 [View Article][PubMed]
    [Google Scholar]
  12. Tan TY, Ng LS. Comparison of three standardized disc susceptibility testing methods for colistin. J Antimicrob Chemother 2006; 58:864–867 [View Article][PubMed]
    [Google Scholar]
  13. Maalej SM, Meziou MR, Rhimi FM, Hammami A. Comparison of disc diffusion, Etest and agar dilution for susceptibility testing of colistin against Enterobacteriaceae. Lett Appl Microbiol 2011; 53:546–551 [View Article][PubMed]
    [Google Scholar]
  14. Piewngam P, Kiratisin P. Comparative assessment of antimicrobial susceptibility testing for tigecycline and colistin against Acinetobacter baumannii clinical isolates, including multidrug-resistant isolates. Int J Antimicrob Agents 2014; 44:396–401 [View Article][PubMed]
    [Google Scholar]
  15. Brown MR, Winsley BE. Synergistic action of polysorbate 80 and polymyxin B sulphate on Pseudomonas aeruginosa. J Gen Microbiol 1968; 50:Suppl:ix[PubMed]
    [Google Scholar]
  16. Poirel L, Jayol A, Nordmann P. Polymyxins: antibacterial activity, susceptibility testing, and resistance mechanisms encoded by plasmids or chromosomes. Clin Microbiol Rev 2017; 30:557–596 [View Article][PubMed]
    [Google Scholar]
  17. Lee SY, Shin JH, Lee K, Joo MY, Park KH et al. Comparison of the Vitek 2, MicroScan, and Etest methods with the agar dilution method in assessing colistin susceptibility of bloodstream isolates of Acinetobacter species from a Korean university hospital. J Clin Microbiol 2013; 51:1924–1926 [View Article][PubMed]
    [Google Scholar]
  18. Lo-Ten-Foe JR, de Smet AM, Diederen BM, Kluytmans JA, van Keulen PH. Comparative evaluation of the VITEK 2, disk diffusion, etest, broth microdilution, and agar dilution susceptibility testing methods for colistin in clinical isolates, including heteroresistant Enterobacter cloacae and Acinetobacter baumannii strains. Antimicrob Agents Chemother 2007; 51:3726–3730 [View Article][PubMed]
    [Google Scholar]
  19. Behera B, Mathur P, Das A, Kapil A, Gupta B et al. Evaluation of susceptibility testing methods for polymyxin. Int J Infect Dis 2010; 14:e596e601 [View Article][PubMed]
    [Google Scholar]
  20. Haeili M, Javani A, Moradi J, Jafari Z, Feizabadi MM et al. MgrB Alterations Mediate Colistin Resistance in Klebsiella pneumoniae Isolates from Iran. Front Microbiol 2017; 8: [View Article][PubMed]
    [Google Scholar]
  21. Haeili M, Kafshdouz M, Feizabadi MM. Molecular Mechanisms of Colistin Resistance Among Pandrug-Resistant Isolates of Acinetobacter baumannii with High Case-Fatality Rate in Intensive Care Unit Patients. Microb Drug Resist 2018 [View Article][PubMed]
    [Google Scholar]
  22. Jorgensen JH PM, Carroll KC, Funke G, Landry ML, Richter SS et al. Manual of Clinical Microbiology, 11th ed. Washington, DC: American Society of Microbiology; 2015
    [Google Scholar]
  23. Turton JF, Woodford N, Glover J, Yarde S, Kaufmann ME et al. Identification of Acinetobacter baumannii by detection of the blaOXA-51-like carbapenemase gene intrinsic to this species. J Clin Microbiol 2006; 44:2974–2976 [View Article][PubMed]
    [Google Scholar]
  24. Wiegand I, Hilpert K, Hancock RE. Agar and broth dilution methods to determine the minimal inhibitory concentration (MIC) of antimicrobial substances. Nat Protoc 2008; 3:163–175 [View Article][PubMed]
    [Google Scholar]
  25. Fda U. Class II Special Controls Guidance Document: Antimicrobial Susceptibility Test (AST) Systems Rockville, MD: US FDA; 2009
    [Google Scholar]
  26. Standardization IOf Clinical Laboratory Testing and in Vitro Diagnostic Test Systems— Susceptibility Testing of Infectious Agents and Evaluation of Performance of Antimicrobial Susceptibility Test Devices—part 2: Evaluation of Performance of Antimicrobial Susceptibility Test Devices International Organization for Standardization:ISO; 2007
    [Google Scholar]
  27. Karvanen M, Malmberg C, Lagerbäck P, Friberg LE, Cars O. Colistin Is Extensively Lost during Standard In Vitro Experimental Conditions. Antimicrob Agents Chemother 2017; 61:e0085700817 [View Article][PubMed]
    [Google Scholar]
  28. Bradford PA, Kazmierczak KM, Biedenbach DJ, Wise MG, Hackel M et al. Colistin-resistant Enterobacteriaceae: correlation of β-lactamase production and colistin resistance among isolates from a global surveillance program. Antimicrobial agents and chemotherapy 2015AAC. 01870–01815
    [Google Scholar]
  29. Hindler JA, Humphries RM. Colistin MIC variability by method for contemporary clinical isolates of multidrug-resistant Gram-negative bacilli. J Clin Microbiol 2013; 51:1678–1684 [View Article][PubMed]
    [Google Scholar]
  30. Hogardt M, Schmoldt S, Götzfried M, Adler K, Heesemann J. Pitfalls of polymyxin antimicrobial susceptibility testing of Pseudomonas aeruginosa isolated from cystic fibrosis patients. J Antimicrob Chemother 2004; 54:1057–1061 [View Article][PubMed]
    [Google Scholar]
  31. Gales AC, Reis AO, Jones RN. Contemporary assessment of antimicrobial susceptibility testing methods for polymyxin B and colistin: review of available interpretative criteria and quality control guidelines. J Clin Microbiol 2001; 39:183–190 [View Article][PubMed]
    [Google Scholar]
  32. Dafopoulou K, Zarkotou O, Dimitroulia E, Hadjichristodoulou C, Gennimata V et al. Comparative Evaluation of Colistin Susceptibility Testing Methods among Carbapenem-Nonsusceptible Klebsiella pneumoniae and Acinetobacter baumannii Clinical Isolates. Antimicrob Agents Chemother 2015; 59:4625–4630 [View Article][PubMed]
    [Google Scholar]
/content/journal/jmm/10.1099/jmm.0.000879
Loading
/content/journal/jmm/10.1099/jmm.0.000879
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