Ahalieyah Anantharajah1, Youri Glupczynski2, Martin Hoebeke2, Pierre Bogaerts2, Philippe Declercq3, Olivier Denis2,4,5, Julie Descy6, Katelijne Floré7, Koen Magerman8, Hector Rodriguez-Villalobos9, Anne-Marie Van den Abeele10, Te-Din Huang2. 1. Department of Clinical Microbiology, National reference center for antibiotic-resistant Gram-negative bacilli, CHU UCL Namur, Yvoir, Belgium. ahalieyah.anantharajah@uclouvain.be. 2. Department of Clinical Microbiology, National reference center for antibiotic-resistant Gram-negative bacilli, CHU UCL Namur, Yvoir, Belgium. 3. Department of Laboratory Medicine, Sint Jozefskliniek, Izegem, Belgium. 4. Ecole de Santé Publique, ULB, Brussels, Belgium. 5. Department of Laboratory Medicine, CHIREC Delta, Brussels, Belgium. 6. Department of Clinical Microbiology, CHU de Liege, Liège, Belgium. 7. Department of Laboratory Medicine, AZ Sint-Lucas, Brugge, Belgium. 8. Department of Laboratory Medicine, Jessa Ziekenhuis, Hasselt, Belgium. 9. Department of Clinical Microbiology, Cliniques Universitaires Saint-Luc, UCL, Brussels, Belgium. 10. Department of Clinical Microbiology, AZ Sint-Lucas, Ghent, Belgium.
Abstract
PURPOSE: Broth microdilution (BMD) stays as the reference testing method for determination of antimicrobial susceptibility testing (AST) to colistin and is considered essential for patient management and for monitoring of colistin resistance. This multicenter study aimed to evaluate the performance of automated systems for colistin AST among Enterobacterales as an alternative for BMD since the majority of laboratories use automated systems as first-line method. METHODS: Twenty colistin resistant (COL-R) including 10 MCR producers and 10 colistin-susceptible (COL-S) Enterobacterales isolates were blindly tested for colistin susceptibility with the routine automated AST systems used by 8 laboratories (3 with BD Phoenix, 3 with Vitek2 and 2 with MicroScan). Additionally, 3 reference strains (E. coli ATCC 25922, E. coli NCTC 13846, and one COL-R mcr-negative K. pneumoniae M/14750) were tested in triplicate by each laboratory. RESULTS AND CONCLUSION: Results were compared with BMD performed at the reference laboratory. BD Phoenix and MicroScan automated AST systems provide accurate and reproducible categorical results for the testing of colistin in Enterobacterales. However, Vitek2 system showed poor performance for the detection of COL-R isolates especially those with MICs close to the susceptibility breakpoint (categorical agreement of 88% and precision categorical agreement of 81%).
PURPOSE: Broth microdilution (BMD) stays as the reference testing method for determination of antimicrobial susceptibility testing (AST) to colistin and is considered essential for patient management and for monitoring of colistin resistance. This multicenter study aimed to evaluate the performance of automated systems for colistin AST among Enterobacterales as an alternative for BMD since the majority of laboratories use automated systems as first-line method. METHODS: Twenty colistin resistant (COL-R) including 10 MCR producers and 10 colistin-susceptible (COL-S) Enterobacterales isolates were blindly tested for colistin susceptibility with the routine automated AST systems used by 8 laboratories (3 with BD Phoenix, 3 with Vitek2 and 2 with MicroScan). Additionally, 3 reference strains (E. coli ATCC 25922, E. coli NCTC 13846, and one COL-R mcr-negative K. pneumoniae M/14750) were tested in triplicate by each laboratory. RESULTS AND CONCLUSION: Results were compared with BMD performed at the reference laboratory. BD Phoenix and MicroScan automated AST systems provide accurate and reproducible categorical results for the testing of colistin in Enterobacterales. However, Vitek2 system showed poor performance for the detection of COL-R isolates especially those with MICs close to the susceptibility breakpoint (categorical agreement of 88% and precision categorical agreement of 81%).
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