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Chapter 6.5 : Susceptibility Testing

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Susceptibility Testing, Page 1 of 2

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Abstract:

The broth microdilution method, providing MICs, is the method recommended for susceptibility testing of the aerobic actinomycetes, including the spp., spp., spp., spp., and spp. ( ). Commercially prepared microdilution plates with the appropriate antimicrobial agents are available, but, in most cases, they are not yet approved by the Food and Drug Administration. The CLSI has published guideline M24-A2, which describes a standard method and interpretation for MIC of aerobic actinomycetes ( ). A disk diffusion test with sulfisoxazole may be used concurrently with microbroth dilution to help with interpretation of an isolate’s susceptibility to the sulfonamide drugs ( ). Some studies indicate that E-test may provide more consistent interpretation than disk diffusion testing ( ).

Citation: Leber A. 2016. Susceptibility Testing, p 6.5.1-6.5.6. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch6.5
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Figures

Image of Figure 6.5–1
Figure 6.5–1

Example of growth and end point determination for species. Trimethoprim-sulfamethoxazole is being read; the susceptible end point is 80% of growth (in the 2+ well).

Citation: Leber A. 2016. Susceptibility Testing, p 6.5.1-6.5.6. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch6.5
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References

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1. CLSI. 2011. Susceptibility Testing of Mycobacteria, Nocardiae, and Other Aerobic Actinomycetes, 2nd ed. Approved standard M24-A2. CLSI, Wayne, PA.
2. CLSI. 2013. Performance Standards for Antimicrobial Susceptibility Testing, 23rd Informational Supplement. Approved standard M100-S23. CLSI, Wayne, PA.
3. CLSI. 2012. Performance Standards for Antimicrobial Susceptibility Testing, 11th ed. Approved standard M02-A11. CLSI, Wayne, PA.
4. Conville PS, Brown-Elliott BA, Wallace RJJr, Witebsky FG, Koziol D, Hall GS, Killian SB, Knapp CC, Warshauer D, Van T, Wengenack NL, Deml S, Woods GL. 2012. Multisite reproducibility of the broth microdilution method for susceptibility testing of Nocardia species. J Clin Microbiol 50:12701280.
5. Conville PS, Witebsky FG. 2011. Nocardia, Rhodococcus, Gordonia, Actinomadura, Streptomyces, and other aerobic actinomycetes, p. 443–471. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th ed. ASM Press, Washington, DC.
6. Brown-Elliott BA, Biehle J, Conville PS, Cohen S, Saubolle M, Sussland D, Wengenack N, Kriel K, Bridge L, McNulty S, Vasireddy R, Wallace RJJr. 2012. Sulfonamide resistance in isolates of Nocardia spp. from a U.S. multicenter survey. J Clin Microbiol 50:670672.
7. Wallace RJJr, Septimus EJ, Musher DM, Martin RR. 1977. Disk diffusion testing of Nocardia species. J Infect Dis 135:568576.
8. Wallace RJJr, Steele L. 1988. Susceptibility testing of Nocardia species for the clinical laboratory. Diagn Microbiol Infect Dis 9:155166.
9. Biehle JR, Cavalieri SJ, Saubolle MA, Get-singer LJ. 1994. Comparative evaluation of E test for susceptibility testing of Nocardia species. Diagn Microbiol Infect Dis 19:101110.
10. Ambaye A, Kohner PC, Wollan PC, Roberts KL, Roberts GD., Cockerill FR, 3rd. 1997. Comparison of agar dilution, broth microdilution, disk diffusion, E-test, and BACTEC radiometric methods for antimicrobial susceptibility testing of clinical isolates of the Nocardia asteroides complex. J Clin Microbiol 35:847852.

Tables

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Table 6.5–1

Quality control ranges of minimum inhibitory concentrations

Citation: Leber A. 2016. Susceptibility Testing, p 6.5.1-6.5.6. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch6.5
Generic image for table
Table 6.5–2

Broth microdilution breakpoint for Nocardia and other aerobic actinomycetes

Citation: Leber A. 2016. Susceptibility Testing, p 6.5.1-6.5.6. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch6.5

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