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Chapter 71 : Susceptibility Test Methods: Dilution and Disk Diffusion Methods*

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Susceptibility Test Methods: Dilution and Disk Diffusion Methods*, Page 1 of 2

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Abstract:

This chapter describes reference dilution (MIC) and disk diffusion antimicrobial susceptibility test methods for nonfastidious, aerobic bacteria. It describes CLSI (United States) and EUcst (European) reference methods and standardized disk diffusion methods. The procedure for performing each test type is described as well as quality control procedures. The advantages and disadvantages of each method are discussed. Finally, the most current interpretive breakpoint criteria for MIC and disk tests from the CLSI are listed.

Citation: Jorgensen J, Turnidge J. 2015. Susceptibility Test Methods: Dilution and Disk Diffusion Methods*, p 1253-1273. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch71
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References

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1. Clinical and Laboratory Standards Institute. 2012. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically, 9th ed. Approved standard M7-A9. CLSI, Wayne, PA.
2. Clinical and Laboratory Standards Institute. 2012. Performance Standards for Antimicrobial Disk Susceptibility Tests, 11th ed. Approved standard M2-A11. CLSI, Wayne, PA.
3. International Organization for Standardization. 2006. Susceptibility Testing of Infectious Agents and Evaluation of Performance of Antimicrobial Susceptibility Devices, part 1. Reference Method for Testing the In Vitro Activity of Antimicrobial Agents against Bacteria Involved in Infectious Diseases, vol I. ISO/DIS 20776-1. International Organization for Standardization, Geneva, Switzerland.
4. Jorgensen JH,, Ferraro MJ. 2009. Antimicrobial susceptibility testing: general principles and contemporary practices. Clin Infect Dis 49:17491755.
5. Clinical and Laboratory Standards Institute. 2008. Development of In Vitro Susceptibility Testing Criteria and Quality Control Parameters; Approved Guideline M23-A3. CLSI, Wayne, PA.
6. Gales AC,, Reis AO,, Jones RN. 2001. Contemporary assessment of antimicrobial susceptibility testing methods for polymyxin B and colistin: review of available interpretative criteria and quality control guidelines. J Clin Microbiol 39: 183190.
7. Jevitt LA,, Thorne GM,, Traczewski MM,, Jones RN,, McGowan JEJr,, Tenover FC,, Brown SD. 2006. Multicenter evaluation of the Etest and disk diffusion methods for differentiating daptomycin-susceptible from non-daptomycin-susceptible Staphylococcus aureus isolates. J Clin Microbiol 44:30983104.
8. Swenson JM,, Anderson KF,, Lonsway DR,, Thompson A,, McAllister SK,, Limbago BM,, Carey RB,, Tenover FC,, Patel JB. 2009. Accuracy of commercial and reference susceptibility testing methods for detecting vancomycin-intermediate Staphylococcus aureus. J Clin Microbiol 47:20132017.
9. Jorgensen JH,, Swenson JM,, Tenover FC,, Ferraro MJ,, Hindler JA,, Murray PR. 1994. Development of interpretive criteria and quality control limits for broth microdilution and disk diffusion antimicrobial susceptibility testing of Streptococcus pneumoniae. J Clin Microbiol 32:24482459.
10. Clinical and Laboratory Standards Institute. 2014. Performance Standards for Antimicrobial Susceptibility Testing. 24th Informational Supplement. M100-S24. CLSI, Wayne, PA.
11. Baddour LM,, Wilson WR,, Bayer AS,, Fowler VGJr,, Bolger AF,, Levison ME,, Ferrieri P,, Gerber MA,, Tani LY,, Gewitz MG,, Tong DC,, Steckelberg JM,, Baltimore RS,, Shulman ST,, Burns JC,, Falace DA,, Newburger JW,, Pallasch TJ,, Takahashi M,, Taubert KA. 2005. Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications. Circulation 111:e394e434.
12. Humphries RM,, Fang FC,, Aarestrup FM,, Hindler JA. 2012. In vitro susceptibility testing of fluoroquinolone activity against Salmonella: recent changes to CLSI standards. Clin Infect Dis 55:11071113.
13. Li XZ. 2005. Quinolone resistance in bacteria: emphasis on plasmid-mediated mechanisms. Int J Antimicrob Agents 25:453463.
14. Tumbarello M,, Viale P,, Viscole C,, Trecarichi EM,, Tuminetto F,, Marchese A,, Spanu T,, Ambretti S,, Ginocchio F,, Cristini F,, Losito AR,, Tedeschi S,, Cauda R,, Bassetti M. 2012. Predictors of mortality in bloodstream infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae: importance of combination therapy. Clin Infect Dis 55:943950.
15. Jorgensen JH. 1993. Selection of antimicrobial agents for routine testing in a clinical microbiology laboratory. Diagn Microbiol Infect Dis 16:245249.
16. Diekema DJ,, Lee K,, Raney P,, Herwaldt LA,, Doern GV,, Tenover FC. 2004. Accuracy and appropriateness of antimicrobial susceptibility test reporting for bacteria isolated from blood cultures. J Clin Microbiol 42:22582260.
17. Jorgensen JH. 1993. Selection criteria for an antimicrobial susceptibility testing system. J Clin Microbiol 31:28412844.
18. Bauer AW,, Sherris JC. 1964. The determination of sulfonamide susceptibility of bacteria. Chemotherapy 15:119.
19. Brenner VC,, Sherris JC. 1972. Influence of different media and bloods on results of diffusion antibiotic susceptibility tests. Antimicrob Agents Chemother 1:116122.
20. Sahm DF,, Baker CN,, Jones RN,, Thornsberry C. 1984. Influence of growth medium on the in vitro activities of second- and third-generation cephalosporins against Streptococcus faecalis. J Clin Microbiol 20:561567.
21. Clinical and Laboratory Standards Institute. 2006. Protocols for Evaluating Dehydrated Mueller-Hinton Agar. Approved Standard M6-A2. CLSI, Wayne, PA.
22. Huang MB,, Gay TE,, Baker CN,, Banerjee SN,, Tenover FC. 1993. Two percent sodium chloride is required for susceptibility testing of staphylococci with oxacillin when using agar-based dilution methods. J Clin Microbiol 31: 26832688.
23. Steers E,, Foltz EL,, Graves BS,, Suriano HJ. 1959. Comparison of bacterial susceptibility to antibiotics as determined by the plate dilution method and by the disc method. Antibiot Annu 7:604613.
24. Hayden MK,, Rezai K,, Hayes RA,, Lolans K,, Quinn JP,, Weinstein RA. 2005. Development of daptomycin resistance in vivo in methicillin-resistant Staphylococcus aureus. J Clin Microbiol 43:52855287.
25. Health Care Financing Administration. 1992. Clinical laboratory improvement amendments of 1988, final rule. Fed Regist 57:70017186.
26. European Committee for Antimicrobial Susceptibility Testing. 2000. Determination of minimum inhibitory concentrations (MICs) of antibacterial agents by agar dilution. Clin Microbiol Infect 6:509515.
27. Barry AL,, Reller LB,, Miller GH,, Washington JA,, Schoenknect FD,, Peterson LR,, Hare RS,, Knapp C. 1992. Revision of standards for adjusting the cation content of Mueller-Hinton broth for testing susceptibility of Pseudomonas aeruginosa to aminoglycosides. J Clin Microbiol 30: 585589.
28. D’Amato RF,, Thornsberry C,, Baker CN,, Kirven LA. 1975. Effect of calcium and magnesium ions on the susceptibility of Pseudomonas species to tetracycline, gentamicin polymyxin B, and carbenicillin. Antimicrob Agents Chemother 7:596600.
29. Turnidge JD,, Bell JM,. 2005. Antimicrobial susceptibility on solid media. In Lorien V (ed), Antibiotics in Laboratory Medicine, 5th ed. Lippincott Williams & Wilkins, Philadelphia, PA.
30. Daly JS,, Dodge RA,, Glew RH,, Soja DT,, DeLuca BA,, Hebert S. 1997. Effect of zinc concentration in Mueller-Hinton agar on susceptibility of Pseudomonas aeruginosa to imipenem. J Clin Microbiol 35:10271029.
31. Fuchs PC,, Barry AL,, Brown SD. 2000. Daptomycin susceptibility tests: interpretive criteria, quality control, and effect of calcium on in vitro tests. Diagn Microbiol Infect Dis 38:5158.
32. Thornsberry C,, McDougal LK. 1983. Successful use of broth microdilution in susceptibility tests for methicillin-resistant (heteroresistant) staphylococci. J Clin Microbiol 18:10841091.
33. Barry AL,, Badal RE,, Hawkinson RW. 1983. Influence of inoculum growth phase on microdilution susceptibility tests. J Clin Microbiol 18:645651.
34. Doern GV. 1987. Breakpoint susceptibility testing. Clin Microbiol Newsl 9:8184.
35. Baker CN,, Stocker SA,, Culver DH,, Thornsberry C. 1991. Comparison of the E Test to agar dilution, broth microdilution, and agar diffusion susceptibility testing techniques by using a special challenge set of bacteria. J Clin Microbiol 29:533538.
36. Huang MB,, Baker CN,, Banerjee S,, Tenover FC. 1992. Accuracy of the E test for determining antimicrobial susceptibilities of staphylococci, enterococci, Campylobacter jejuni, and gram-negative bacteria resistant to antimicrobial agents. J Clin Microbiol 30:32433248.
37. Pfaller MA,, Jones RN. 2006. Performance accuracy of antibacterial and antifungal susceptibility test methods: report from the College of American Pathologists Microbiology Surveys Program (2001–2003). Arch Pathol Lab Med 130:767778.
38. Bauer AW,, Kirby WM,, Sherris JC,, Turck M. 1966. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol 45:493496.
39. Brunden MN,, Zurenko GE,, Kapik B. 1992. Modification of the error-rate bounded classification scheme for use with two MIC break points. Diagn Microbiol Infect Dis 15:135140.
40. Metzler CM,, DeHaan RM. 1974. Susceptibility tests of anaerobic bacteria: statistical and clinical considerations. J Infect Dis 130:588594.
41. Berke I,, Tierno PMJr. 1996. Comparison of efficacy and cost-effectiveness of BIOMIC VIDEO and Vitek antimicrobial susceptibility test systems for use in the clinical microbiology laboratory. J Clin Microbiol 34:19801984.
42. Medeiros AA,, Crellin J. 2000. Evaluation of the Sirscan automated zone reader in a clinical microbiology laboratory. J Clin Microbiol 38:16881693.
43. Clinical and Laboratory Standards Institute. 2010. Methods for Antimicrobial Dilution and Disk Susceptibility Testing of Infrequently-Isolated or Fastidious Bacteria. Proposed guideline M45-A2. CLSI, Wayne, PA.
44. Tenover FC,, Lancaster MV,, Hill BC,, Steward CD,, Stocker SA,, Hancock GA,, O’Hara CM,, McAllister SK,, Clark NC,, Hiramatsu K. 1998. Characterization of staphylococci with reduced susceptibilities to vancomycin and other glycopeptides. J Clin Microbiol 36:10201027.
45. Tenover FC,, McDonald LC. 2005. Vancomycin-resistant staphylococci and enterococci: epidemiology and control. Curr Opin Infect Dis 18:300305.
46. Lewis JSII,, Owens A,, Cadena J,, Sabol K,, Patterson JE,, Jorgensen JH. 2005. Emergence of daptomycin resistance in Enterococcus faecium during daptomycin therapy. Antimicrob Agents Chemother 49:16641665.
47. de Lencastre H,, Sa Figueiredo AM,, Urban C,, Rahal J,, Tomasz A. 1991. Multiple mechanisms of methicillin resistance and improved methods for detection in clinical isolates of Staphylococcus aureus. Antimicrob Agents Chemother 35:632639.
48. Rosenberg J,, Tenover FC,, Wong J,, Jarvis W,, Vugia DJ. 1997. Are clinical laboratories in California accurately reporting vancomycin-resistant enterococci? J Clin Microbiol 35:25262530.
49. Coyle MB,, Lampe MF,, Aitken CL,, Feigl P,, Sherris JC. 1976. Reproducibility of control strains for antibiotic susceptibility testing. Antimicrob Agents Chemother 10:436440.
50. Swenson JM,, Brasso WB,, Ferraro MJ,, Hardy DJ,, Knapp CC,, Lonsway D,, McAllister S,, Reller LB,, Sader HS,, Shortridge D,, Skov R,, Weinstein MP,, Zimmer BL,, Patel JB. 2009. Correlation of cefoxitin MICs with the presence of mecA in Staphylococcus spp. J Clin Microbiol 47:19021905.
51. Swenson JM,, Tenover FC. 2005. Results of disk diffusion testing with cefoxitin correlate with presence of mecA in Staphylococcus spp. J Clin Microbiol 43:38183823.
52. Lewis JSII,, Jorgensen JH. 2005. Inducible clindamycin resistance in Staphylococci: should clinicians and microbiologists be concerned? Clin Infect Dis 40:280285.
53. Jorgensen JH,, McElmeel ML,, Fulcher LC,, McGee L,, Glennen A. 2011. Evaluation of disk approximation and single well broth tests for detection of inducible clindamycin resistance in Streptococcus pneumoniae. J Clin Microbiol 49:33323333.
54. Fiebelkorn KR,, Crawford SA,, McElmeel ML,, Jorgensen JH. 2003. Practical disk diffusion method for detection of inducible clindamycin resistance in Staphylococcus aureus and coagulase-negative staphylococci. J Clin Microbiol 41:47404744.
55. Jorgensen JH,, McElmeel ML,, Fulcher LC,, McGee L,, Richter SS,, Heilman KP,, Ferraro MJ,, Glennen A. 2011. Collaborative evaluation of an erythromycin-clindamycin combination well for detection of inducible clindamycin resistance in beta-hemolytic streptococci using the CLSI broth microdilution method. J Clin Microbiol 49:28842886.
56. Swenson JM,, Brasso WB,, Ferraro MJ,, Hardy DJ,, Knapp CC,, McDougal LK,, Reller LB,, Sader HS,, Shortridge D,, Skov R,, Weinstein MP,, Zimmer BL,, Patel JB. 2007. Detection of inducible clindamycin resistance in staphylococci by broth microdilution using erythromycin-clindamycin combination wells. J Clin Microbiol 45:39543957.
57. Brown DFJ. 1994. Developments in antimicrobial susceptibility testing. Rev Med Microbiol 5:6575.
58. Ferraro MJ. 2001. Should we reevaluate antibiotic breakpoints? Clin Infect Dis 33(Suppl 3):S227S229.
59. Turnidge J,, Kahlmeter G,, Kronvall G. 2006. Statistical characterisation of bacterial wild-type MIC value distributions and the determination of epidemiological cut-off values. Clin Microbiol Infect 12:418425.
60. Kahlmeter G,, Brown DF,, Goldstein FW,, MacGowan AP,, Mouton JW,, Odenholt I,, Rodloff A,, Soussy CJ,, Steinbakk M,, Soriano F,, Stetsiouk O. 2006. European Committee on Antimicrobial Susceptibility Testing (EUCAST) technical notes on antimicrobial susceptibility testing. Clin Microbiol Infect 12:501503.
61. International Organization for Standardization. 2006. Susceptibility Testing of Infectious Agents and Evaluation of Performance of Antimicrobial Susceptibility Devices, part 2. Evaluation of Performance of Antimicrobial Susceptibility Test Devices, vol. ISO/DIS 20776-2. International Organization for Standardization, Geneva, Switzerland.
62. Wheat PF. 1989. The agar-dilution susceptibility technique: past and present. Clin Microbiol Newsl 11:164166.
63. Japanese Society for Chemotherapy. 1993. Report of the Committee for Japanese Standards for Antimicrobial Susceptibility Testing for Bacteria. Chemotherapy 41:183189.
64. Japanese Society for Chemotherapy. 1990. Report of the Committee for Japanese Standards for Antimicrobial Susceptibility Testing for Bacteria. Chemotherapy 38:102105.
65. Andrews JM. 2001. Determination of minimum inhibitory concentrations. J Antimicrob Chemother 48(Suppl 1):516.
66. Andrews JM. 2001. BSAC standardized disc susceptibility testing method. J Antimicrob Chemother 48(Suppl 1):4357.
67. McDermott SN,, Hartley TF. 1989. New datum handling methods for the quality control of antibiotic solutions and plates used in the antimicrobial susceptibility test. J Clin Microbiol 27:18141825.
68. Andrews JM,, Boswell FJ,, Wise R. 2000. Evaluation of the Oxoid Aura image system for measuring zones of inhibition with the disc diffusion technique. J Antimicrob Chemother 46:535540.
69. Toohey M,, Francis G,, Stingemore N. 1990. Variation in Iso-Sensitest agar affecting β-lactam testing. Newsl Antimicrob Spec Interest Group Aust Soc Microbiol 6:68.
70. Ward PB,, Palladino S,, Looker JC,, Feddema P. 1993. p-nitrophenylglycerol in susceptibility testing media alters the MICs of antimicrobials for Pseudomonas aeruginosa. J Antimicrob Chemother 31:489496.
71. Ward P,, Palladino S,, McLaren B,, Rathur RJ,, Looker JC. 1993. The effect of increased agar concentration in susceptibility testing media on MICs of antimicrobials for gram-negative bacilli. J Antimicrob Chemother 31:10051007.
72. Williams JD. 1990. Prospects for standardisation of methods and guidelines for disc susceptibility testing. Eur J Clin Microbiol Infect Dis 9:496501.
73. British Society for Antimicrobial Chemotherapy. 1991. A guide to sensitivity testing. Report of the Working Party on Antibiotic Sensitivity Testing of the British Society for Antimicrobial Chemotherapy. J Antimicrob Chemother 27(Suppl D):150.
74. Brown DF. 1990. The comparative methods of antimicrobial susceptibility testing—time for a change? J Antimicrob Chemother 25:307310.
75. MacGowan AP,, Wise R. 2001. Establishing MIC breakpoints and the interpretation of in vitro susceptibility tests. J Antimicrob Chemother 48(Suppl 1):1728.
76. Members of the SFM Antibiogram Committee. 2003. Comite de l’Antibiogramme de la Societe Francaise de Microbiologie report 2003. Int J Antimicrob Agents 21:364391.
77. Deutches Institut fur Normung. 2002. Susceptibility Testing of Pathogens to Antimicrobial Agents, part 3. Agar Diffusion Test, vol. DIN 58940-3. Beuth Verlag, Berlin, Germany.
78. Deutches Institut fur Normung. 2003. Susceptibility Testing of Pathogens to Antimicrobial Agents, part 6. Determination of the Minimum Inhibitory Concentration (MIC) with the Agar Dilution Method, vol. DIN 58940-6. Beuth Verlag, Berlin, Germany.
79. Olsson-Liljequist B,, Larsson P,, Walder M,, Miorner H. 1997. Antimicrobial susceptibility testing in Sweden. III. Methodology for susceptibility testing. Scand J Infect Dis Suppl 105:1323.
80. Swedish Reference Group for Antibiotics. 1981. A revised system for antibiotic sensitivity testing. Scand J Infect Dis 13:148152.
81. Ericsson HM,, Sherris JC. 1971. Antibiotic sensitivity testing. Report of an international collaborative study. Acta Pathol Microbiol Scand Sect B Suppl 217:190.
82. Ringertz S,, Olsson-Liljequist B,, Kahlmeter G,, Kronvall G. 1997. Antimicrobial susceptibility testing in Sweden. II. Species-related zone diameter breakpoints to avoid interpretive errors and guard against unrecognized evolution of resistance. Scand J Infect Dis Suppl 105:812.
83. Bell SM. 1988. Additions and modifications to the range of antibiotics tested by the CDS method of antibiotic sensitivity testing. Pathology 20:303304.
84. Bell SM. 1975. The CDS disc method of antibiotic sensitivity testing (calibrated dichotomous sensitivity test). Pathology 7(Suppl):148.
85. Chaitram JM,, Jevitt LA,, Lary S,, Tenover FC. 2003. The World Health Organization’s External Quality Assurance System Proficiency Testing Program has improved the accuracy of antimicrobial susceptibility testing and reporting among participating laboratories using NCCLS methods. J Clin Microbiol 41:23722377.
86. King A,, Brown DF. 2001. Quality assurance of antimicrobial susceptibility testing by disc diffusion. J Antimicrob Chemother 48(Suppl 1):7176.
87. Tenover FC,, Swenson JM,, O’Hara CM,, Stocker SA. 1995. Ability of commercial and reference antimicrobial susceptibility testing methods to detect vancomycin resistance in enterococci. J Clin Microbiol 33:15241527.
88. Queenan AM,, Bush K. 2007. Carbapenemases: the versatile β-lactamases. Clin Microbiol Rev 20:440458.

Tables

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TABLE 1

Antimicrobial agents recommended for routine dilution and disk diffusion susceptibility testing

Citation: Jorgensen J, Turnidge J. 2015. Susceptibility Test Methods: Dilution and Disk Diffusion Methods*, p 1253-1273. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch71
Generic image for table
TABLE 2

Interpretive criteria (breakpoints) for dilution and disk diffusion susceptibility tests for commonly prescribed antimicrobial agents

Citation: Jorgensen J, Turnidge J. 2015. Susceptibility Test Methods: Dilution and Disk Diffusion Methods*, p 1253-1273. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch71
Generic image for table
TABLE 3

Non-United States disk diffusion methods for susceptibility testing

Citation: Jorgensen J, Turnidge J. 2015. Susceptibility Test Methods: Dilution and Disk Diffusion Methods*, p 1253-1273. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch71

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