Evaluation of 500 gram negative isolates to determine the number of major susceptibility interpretation discrepancies between the Vitek and MicroScan Walkaway for 9 antimicrobial agents.

Although the Vitek and MicroScan Walkaway are two of the most commonly used automated antimicrobial susceptibility test systems, few studies have been performed comparing discrepancies between these systems. In this study, 500 Gram negative clinical isolates were tested against ampicillin, ampicillin/sulbactam, ticarcillin, ticarcillin/clavulanate, imipenem, ciprofloxacin, norfloxacin, mezlocillin, and piperacillin to determine the number of major interpretation discrepancies between the two systems. The 500 isolates consisted of 100 isolates each of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis and Enterobacter species. Each isolate was tested simultaneously in both systems using the same standardized inoculum. Eighty-four major discrepancies occurred, of which 48 were reproducible. The reproducible discrepancy rate, for the 4,500 isolate/antimicrobic combinations tested, was 48 of 4500 (1.06%). The rate for individual antimicrobics varied from 17 of 500 (3.4%) for ampicillin to no discrepancies for ticarcillin or ciprofloxacin. Of the 48 reproducible discrepancies, 44 (92%) were Vitek resistant, MicroScan susceptible. Fifteen (31%) of the Vitek and 21 (44%) of the MicroScan results were confirmed by broth microdilution. Disk diffusion results were in agreement with 15 (31%) of the Vitek and 21 (44%) of the MicroScan results. Twelve (25%) of the broth microdilution and 12 (25%) of the disk diffusion results were intermediate. The broth microdilution and disk diffusion results for the 48 isolates with reproducible discrepancies were in agreement more often with MicroScan. However, there was less very major error comparing the Vitek results for these isolates to the broth microdilution and disk diffusion. Overall, the result of this evaluation indicate that the number of major interpretation discrepancies between the two systems is minimal for the isolate/antimicrobic combinations tested.