Evaluation of antibiotic susceptibility test results: how guilty a laboratory could be?
Abstract Background The selection of an appropriate antimicrobial is a challenging task for clinicians. The Kirby-Bauer disk diffusion method is one of the most widely practiced antimicrobial susceptibility tests (AST). It is affected by many factors among which are the media used. Mueller-Hinton ag...
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ftdoajarticles:oai:doaj.org/article:06112a9038c54e45bbee98046e9fc673 2023-05-15T15:12:06+02:00 Evaluation of antibiotic susceptibility test results: how guilty a laboratory could be? Mohamed S. M. Nassar Walaa A. Hazzah Wafaa M. K. Bakr 2019-01-01T00:00:00Z https://doi.org/10.1186/s42506-018-0006-1 https://doaj.org/article/06112a9038c54e45bbee98046e9fc673 EN eng SpringerOpen http://link.springer.com/article/10.1186/s42506-018-0006-1 https://doaj.org/toc/2090-262X doi:10.1186/s42506-018-0006-1 2090-262X https://doaj.org/article/06112a9038c54e45bbee98046e9fc673 Journal of the Egyptian Public Health Association, Vol 94, Iss 1, Pp 1-5 (2019) CLSI Mueller-Hinton agar Inhibition zones Disk diffusion method Quality control Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2019 ftdoajarticles https://doi.org/10.1186/s42506-018-0006-1 2022-12-31T02:52:20Z Abstract Background The selection of an appropriate antimicrobial is a challenging task for clinicians. The Kirby-Bauer disk diffusion method is one of the most widely practiced antimicrobial susceptibility tests (AST). It is affected by many factors among which are the media used. Mueller-Hinton agar (MHA) is the standard medium recommended in guidelines. However, these guidelines are not strictly adhered to in some developing countries. Objectives Validation of AST results on nutrient agar (NA) medium used as a substitute for MHA by some microbiology laboratories in Alexandria, Egypt. Methods A total of 149 clinical bacterial isolates and 3 reference strains: Staphylococcus aureus (S. aureus) ATCC® 25923, Escherichia coli (E. coli) ATCC®25922, and Pseudomonas aeruginosa (P. aeruginosa) ATCC®27853 were comparatively challenged to antibiotics employing MHA and NA. Results All antibiotics-reference bacterial strain challenges on NA compared to MHA were unacceptable (> 3 out of limit zones in 30 consecutive days). Considering clinical isolates, the frequency of very major, major, and minor errors on NA was highest in the case of P. aeruginosa (8.98%, 4.08%, and 14.7% respectively) followed by S. aureus (7.6%, 6%, and 8.8% respectively). On the other hand, the least frequency of errors was in the case of Enterobacteriaceae (0%, 0.4%, and 3.2% respectively). Conclusions and recommendations Using NA in AST resulted in multiple errors and the high discrepancy in results compared to MHA making it unreliable for susceptibility testing. MHA should not be replaced by NA in AST. Following guidelines and QC measures for AST must be neither bypassed nor underestimated. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Mueller ENVELOPE(55.533,55.533,-66.917,-66.917) Journal of the Egyptian Public Health Association 94 1 |
institution |
Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
CLSI Mueller-Hinton agar Inhibition zones Disk diffusion method Quality control Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
CLSI Mueller-Hinton agar Inhibition zones Disk diffusion method Quality control Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Mohamed S. M. Nassar Walaa A. Hazzah Wafaa M. K. Bakr Evaluation of antibiotic susceptibility test results: how guilty a laboratory could be? |
topic_facet |
CLSI Mueller-Hinton agar Inhibition zones Disk diffusion method Quality control Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Abstract Background The selection of an appropriate antimicrobial is a challenging task for clinicians. The Kirby-Bauer disk diffusion method is one of the most widely practiced antimicrobial susceptibility tests (AST). It is affected by many factors among which are the media used. Mueller-Hinton agar (MHA) is the standard medium recommended in guidelines. However, these guidelines are not strictly adhered to in some developing countries. Objectives Validation of AST results on nutrient agar (NA) medium used as a substitute for MHA by some microbiology laboratories in Alexandria, Egypt. Methods A total of 149 clinical bacterial isolates and 3 reference strains: Staphylococcus aureus (S. aureus) ATCC® 25923, Escherichia coli (E. coli) ATCC®25922, and Pseudomonas aeruginosa (P. aeruginosa) ATCC®27853 were comparatively challenged to antibiotics employing MHA and NA. Results All antibiotics-reference bacterial strain challenges on NA compared to MHA were unacceptable (> 3 out of limit zones in 30 consecutive days). Considering clinical isolates, the frequency of very major, major, and minor errors on NA was highest in the case of P. aeruginosa (8.98%, 4.08%, and 14.7% respectively) followed by S. aureus (7.6%, 6%, and 8.8% respectively). On the other hand, the least frequency of errors was in the case of Enterobacteriaceae (0%, 0.4%, and 3.2% respectively). Conclusions and recommendations Using NA in AST resulted in multiple errors and the high discrepancy in results compared to MHA making it unreliable for susceptibility testing. MHA should not be replaced by NA in AST. Following guidelines and QC measures for AST must be neither bypassed nor underestimated. |
format |
Article in Journal/Newspaper |
author |
Mohamed S. M. Nassar Walaa A. Hazzah Wafaa M. K. Bakr |
author_facet |
Mohamed S. M. Nassar Walaa A. Hazzah Wafaa M. K. Bakr |
author_sort |
Mohamed S. M. Nassar |
title |
Evaluation of antibiotic susceptibility test results: how guilty a laboratory could be? |
title_short |
Evaluation of antibiotic susceptibility test results: how guilty a laboratory could be? |
title_full |
Evaluation of antibiotic susceptibility test results: how guilty a laboratory could be? |
title_fullStr |
Evaluation of antibiotic susceptibility test results: how guilty a laboratory could be? |
title_full_unstemmed |
Evaluation of antibiotic susceptibility test results: how guilty a laboratory could be? |
title_sort |
evaluation of antibiotic susceptibility test results: how guilty a laboratory could be? |
publisher |
SpringerOpen |
publishDate |
2019 |
url |
https://doi.org/10.1186/s42506-018-0006-1 https://doaj.org/article/06112a9038c54e45bbee98046e9fc673 |
long_lat |
ENVELOPE(55.533,55.533,-66.917,-66.917) |
geographic |
Arctic Mueller |
geographic_facet |
Arctic Mueller |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Journal of the Egyptian Public Health Association, Vol 94, Iss 1, Pp 1-5 (2019) |
op_relation |
http://link.springer.com/article/10.1186/s42506-018-0006-1 https://doaj.org/toc/2090-262X doi:10.1186/s42506-018-0006-1 2090-262X https://doaj.org/article/06112a9038c54e45bbee98046e9fc673 |
op_doi |
https://doi.org/10.1186/s42506-018-0006-1 |
container_title |
Journal of the Egyptian Public Health Association |
container_volume |
94 |
container_issue |
1 |
_version_ |
1766342830866825216 |