Comparative evaluation of susceptibility testing methods for colistin and polymyxin B among clinical isolates of carbapenem- resistant Klebsiella pneumoniae and Acinetobacter baumannii | Zendy

Yamuna Devi Bakthavatchalam | Zendy; Abirami Shankar | Zendy; Bhuvaneswari Thukaram | Zendy; Dhanabhagyam Naveena Krishnan | Zendy; Balaji Veeraraghavan | Zendy

Open Access

Comparative evaluation of susceptibility testing methods for colistin and polymyxin B among clinical isolates of carbapenem- resistant Klebsiella pneumoniae and Acinetobacter baumannii

Author(s) -

Yamuna Devi Bakthavatchalam,

Abirami Shankar,

Bhuvaneswari Thukaram,

Dhanabhagyam Naveena Krishnan,

Balaji Veeraraghavan

Publication year - 2018

Publication title -

the journal of infection in developing countries

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.322

H-Index - 49

eISSN - 2036-6590

pISSN - 1972-2680

DOI - 10.3855/jidc.9660

Subject(s) - colistin , polymyxin b , acinetobacter baumannii , polymyxin , medicine , broth microdilution , klebsiella pneumoniae , microbiology and biotechnology , antibiotics , biology , minimum inhibitory concentration , pseudomonas aeruginosa , bacteria , biochemistry , genetics , escherichia coli , gene

Susceptibility testing (ST) of colistin and polymyxin B is challenging. Disc diffusion testing is not reliable for polymyxin ST, because of poor diffusion. Currently, for polymyxin ST, the EUCAST-CLSI joint commission recommending broth microdilution (BMD) as the reference method. In this study, reliability of E-test and Vitek 2 was compared with BMD, using the susceptible breakpoint of ≤ 2μg/ml for both colistin and polymyxin B. Overall, essential agreement (EA) for colistin between E-test, Vitek2 and BMD were 37% and 74% respectively. EA for polymyxin B between E-test and BMD were 65%. Very major error (VME) for colistin and polymyxin B with E-test were 42% and 55% respectively. An unacceptable VME of 11% was seen for colistin with Vitek2. Major errors (MEs) were rather limited with both E-test and Vitek2. E-test and Vitek2 may lead to inappropriate decision-making for colistin/polymyxin B therapy. Thus, clinical laboratories should consider BMD for polymyxin ST.

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