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Short incubation of disc diffusion for Streptococcus pneumoniae and Haemophilus influenzae to reduce time to susceptibility report
Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Microbiology.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Microbiology.ORCID iD: 0000-0002-9058-3582
Orebro Univ, Sweden.
2023 (English)In: Journal of Antimicrobial Chemotherapy, ISSN 0305-7453, E-ISSN 1460-2091, Vol. 78, no 10, p. 2563-2571Article in journal (Refereed) Published
Abstract [en]

Background Rapidly instituted antimicrobial therapy is important in severe infections, and reduced time to the antimicrobial susceptibility testing (AST) report is thus of importance. Disc diffusion (DD) is a cheap, rapidly adaptable, flexible and comprehensive method for phenotypic AST. Previous studies have shown that early reading of inhibition zones for non-fastidious species is possible.Objectives To evaluate zone reading after short incubation of DD in Haemophilus influenzae (n = 73) and Streptococcus pneumoniae (n = 112).Methods The readability was evaluated and susceptibility interpretation (SIR) was performed, using the EUCAST 18 & PLUSMN; 2 h incubation breakpoint table (version 12.0), after 6 and 8 h of incubation. Categorical agreement (CA) and error rates were calculated using standard DD and broth microdilution as reference.Results The proportion of readable zones in H. influenzae was 19% (6 h) and 89% (8 h). The CA was 98% after 8 h. The corresponding readability in S. pneumoniae was 63%/98% and CA was 95%/97% after 6 and 8 h, respectively. Early reading of the screening discs (benzylpenicillin 1 unit in H. influenzae and oxacillin 1 & mu;g in S. pneumoniae) correctly identified 18/22 of the H. influenzae isolates and all the readable S. pneumoniae isolates with reduced & beta;-lactam susceptibility. For non-& beta;-lactam agents, very major errors were most common for quinolones in S. pneumoniae. Introduction of areas of technical uncertainty (ATUs) reduced the error rate to & LE;1.1%.Conclusions We conclude that shortened incubation is feasible for H. influenzae and S. pneumoniae. To reduce the risk of false categorization a buffer zone (i.e. ATU) near the breakpoints must be used.

Place, publisher, year, edition, pages
OXFORD UNIV PRESS , 2023. Vol. 78, no 10, p. 2563-2571
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:liu:diva-197858DOI: 10.1093/jac/dkad272ISI: 001058258900001PubMedID: 37667593OAI: oai:DiVA.org:liu-197858DiVA, id: diva2:1798181
Note

Funding Agencies|Part of the results from this study have been presented at the Thirtieth NSCMID, Aarhus; Denmark 2013 (Abstract and poster: Susceptibility testing of Haemophilus influenzae with DD interpreted after 8 h of incubation using EUCAST methodology and Twenty-Fo

Available from: 2023-09-18 Created: 2023-09-18 Last updated: 2024-02-12

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Åkerlund, AnnaSerrander, Lena
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