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Chapter 7.8 : Susceptibility Tests by Modified Agar Proportion

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Abstract:

The BACTEC 460TB radiometric antimicrobial susceptibility test (Becton Dickinson Diagnostic Systems, Sparks, Md.) is a rapid method based on the principle used for primary isolation of mycobacteria. A C-labeled substrate is incorporated in BACTEC 12B medium. When mycobacteria grow in the medium, CO is produced during metabolism, which is measured as the growth index (GI). If a test drug to which mycobacteria are susceptible is added to this medium, the growth is inhibited, resulting in diminishing GIs as measured by the BACTEC 460 instrument. Radiometric antimicrobial susceptibility testing of has been well documented and widely used ( ). Results show good agreement with the agar proportion method and are available within 4 to 6 days, compared with 3 weeks with the conventional method.

Citation: Garcia L. 2010. Susceptibility Tests by Modified Agar Proportion, p 351-381. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch7.8
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References

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1. Canetti, G.,, W. Fox,, A. Khomenko,, N. Mahlor,, N. K. T. Menon,, D. A. Mitchinson,, N. Rist,, and J. A. Smelev. 1969. Advances in techniques of testing mycobacterial drug susceptibility, and the use of sensitivity tests in tuberculosis programs. Bull. W. H. O. 41:2143.
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5. Pfyffer, G. E.,, D. A. Bonato,, A. Ebrahimzadeh,, W. Gross,, J. Hotaling,, J. Kornblum,, A. Laszlo,, G. Roberts,, M. Salfinger,, F. Wittmer,, and S. Siddiqi. 1999. Multicenter laboratory validation of susceptibility testing of Mycobacterium tuberculosis against classical second-line and newer antimicrobial drugs by using the radiometric BACTEC 460 technique and the proportion method with solid media. J. Clin. Microbiol. 37:31793186.
6. Robert, G. D.,, N. L. Goodman,, L. Heifets,, H. W. Larsh,, T. H. Lindner,, J. R. Mc- Clatchy,, M. R. McGinnis,, S. H. Siddiqi,, and P. Wright. 1983. Evaluation of BACTEC radiometric method for recovery of mycobacteria and drug susceptibility testing of Mycobacterium tuberculosis from acid-fast smear-positive specimens. J. Clin. Microbiol. 18:689696.
7. Siddiqi, S. H.,, J. P. Libonati,, M. E. Carter,, N. M. Hooper,, J. F. Baker,, C. C. Hwangbo,, and L. E. Warfel. 1988. Enhancement of mycobacterial growth in Middlebrook 7H12 medium by polyoxyethylene stearate. Curr. Microbiol. 17:105110.
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3. Salfinger, M.,, and L. Heifets. 1988. Determination of pyrazinamide MICs for Mycobacterium tuberculosis at different pHs by the radiometric method. Antimicrob. Agents Chemother. 32:10021004.
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Tables

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Citation: Garcia L. 2010. Susceptibility Tests by Modified Agar Proportion, p 351-381. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch7.8
Generic image for table
Untitled

Citation: Garcia L. 2010. Susceptibility Tests by Modified Agar Proportion, p 351-381. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch7.8
Generic image for table
Untitled

BACTEC 12B (Middlebrook 7H12) liquid medium. Antimicrobial agents are added to the medium prior to testing.

LJ, Lowenstein-Jensen egg medium. Antimicrobial agents are added before inspissation.

Middlebrook agar medium. Antimicrobial agents are added before plates are poured.

Recommended concentration.

NA, not available.

—, no recommendations due to inconsistent results.

Citation: Garcia L. 2010. Susceptibility Tests by Modified Agar Proportion, p 351-381. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch7.8
Generic image for table
Untitled

Equivalent drug concentrations in BACTEC 12B and solid media: secondary drugs

BACTEC 12B (Middlebrook 7H12) liquid medium. Antimicrobial agents are added to the medium prior to testing.

LJ, Lowenstein-Jensen egg medium. Antimicrobial agents are added before inspissation.

Middlebrook agar medium. Antimicrobial agents are added before plates are poured.

Recommended concentration.

—, no recommendations due to inconsistent results.

Citation: Garcia L. 2010. Susceptibility Tests by Modified Agar Proportion, p 351-381. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch7.8
Generic image for table
Untitled

Equivalent drug concentrations in BACTEC 460 and solid media: secondary drugs

Citation: Garcia L. 2010. Susceptibility Tests by Modified Agar Proportion, p 351-381. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch7.8
Generic image for table
Untitled

Citation: Garcia L. 2010. Susceptibility Tests by Modified Agar Proportion, p 351-381. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch7.8
Generic image for table
Untitled

Reconstitute using 4 ml of sterile distilled and deionized water.

Citation: Garcia L. 2010. Susceptibility Tests by Modified Agar Proportion, p 351-381. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch7.8
Generic image for table
Untitled

Reconstitute using 2 ml of sterile distilled and deionized water.

Citation: Garcia L. 2010. Susceptibility Tests by Modified Agar Proportion, p 351-381. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch7.8
Generic image for table
Untitled

Equivalent to CDC-recommend critical drug concentrations

Citation: Garcia L. 2010. Susceptibility Tests by Modified Agar Proportion, p 351-381. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch7.8
Generic image for table
Table 7.8.7-1

Drug concentrations

Citation: Garcia L. 2010. Susceptibility Tests by Modified Agar Proportion, p 351-381. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch7.8

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