Evaluation of the BD Phoenix100 System and Colistin Broth Disk Elution Method for Antimicrobial Susceptibility Testing of Colistin Against Gram-negative Bacteria

Özyurt, Özlem Koyuncu; Özhak, Betil; Öğünç, Dilara; Yıldız, Emre; Çolak, Dilek; Günseren, Filiz; Öngüt, Gözde

doi:10.5578/mb.68066

Cited by 8 publications

(5 citation statements)

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“…When the disk elution method was evaluated by Simmer et al, they found 98% CA and 99% EA, with no errors at all [13]. Koyuncu et al also evaluated this method compared to BMD and found 99% CA with 0.5% very major errors [24]. In the present study, the disk elution method had 100% CA and 100% EA, with no errors at all (Figure 3).…”

Section: Discussionsupporting

confidence: 55%

“…When automated systems are used to detect the MIC of colistin, it comes into contact with the plastic at every stage of the test, and concentration losses occur due to the adhesion of colistin to the plastic and causes resistant strains to appear susceptible. For this reason, most studies reported that various automated systems such as Phoenix 100, Microscan, and VITEK-2, are not reliable [23][24][25]. Although there are various colistin susceptibility tests, there is still no practical, easy-touse, and low-cost method that can be used in routine laboratories instead of BMD.…”

Section: Discussionmentioning

confidence: 99%

“…Studies testing colistin susceptibility using BMD in Greece, Italy, India, Egypt, Germany, and Poland found resistance rates of 95.1%, 13.5%, 32.4%, 45.1%, and 17%, respectively [32][33][34][35][36][37]. Colistin resistance has been detected in many studies conducted in Turkey, and resistance rates vary between 27% and 60% [24,38,39].…”

Section: Discussionmentioning

confidence: 99%

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Detection of colistin resistance via four methods in multidrug-resistant Gram-negative rods isolated from blood cultures

Alhamwi

Öksüz

2022

J Infect Dev Ctries

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Introduction: The broth microdilution (BMD) method recommended for the detection of colistin resistance is labor-intensive, time-consuming, and difficult to apply in routine laboratories. Thus, various methods, such as disk elution, commercial microdilution, and rapid polymyxin-NP tests have been developed for the detection of colistin resistance. In this study, a total of 102 multi-resistant Gram-negative bacteria isolated from blood cultures were evaluated by four different methods for the detection of colistin resistance, and compared with the reference method. Methodology: For the detection of the compatibility of these methods with the reference method, categorical and essential agreements, very major, major, and minor error rates were determined. Colistin-tigecycline and colistin-meropenem combinations were investigated in colistin-resistant isolates. Results: Of the isolates, 15 (15%) [K. pneumoniae (n = 12), A. baumannii (n = 2), E. coli (n = 1)] were resistant to colistin with reference BMD method. MIC50 and MIC90 values of all isolates were ≤ 0.25 μg/mL and 16 μg/mL, respectively. The categorical agreement rates were 100% for commercial microdilution, disk elution, and RPNP test. The essential agreement rates of commercial microdilution, disk elution, and broth macrodilution were 78.4%, 86.3%, and 100%, respectively. Although there were no major errors in these methods, the macrodilution (12%) and commercial microdilution (20.6%) methods showed the most minor errors. Colistin-meropenem combination showed a 100% synergistic effect, but the colistin-tigecycline combination showed an 80% synergistic effect and 20% indifference effect. Conclusions: Disk elution and RPNP tests are suitable for routine use because they are the most efficient, easiest, low-cost, and good performance tests in detecting colistin resistance.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

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Detection of colistin resistance via four methods in multidrug-resistant Gram-negative rods isolated from blood cultures

Alhamwi

Öksüz

2022

J Infect Dev Ctries

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“…Simner et al [ 6 ] found 98 % CA, 99 % EA and no errors with this method. Koyuncu et al found 99 % CA with 0.5 % very major errors [ 34 ]. In our study, the EA and CA were acceptable with 14 VMEs and 97 MEs by CBDE.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of different methods for in vitro susceptibility testing of colistin in carbapenem resistant Gram-negative bacilli

Rout,

Dash,

Sahu

et al. 2023

Access Microbiology

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Introduction. The increasing antibiotic resistance like the advent of carbapenem resistant Enterobactarales (CRE), Carbapenem Resistant Acinetobacter baumanii (CRAB), and Carbapenem Resistant Pseudomonas aeruginosa (CRPA) has led to to the use of toxic and older drugs like colistin for these organisms. But worldwide there is an increase in resistance even to colistin mediated both by chromosomes and plasmids. This necessitates accurate detection of resistance. This is impeded by the unavailability of a user-friendly phenotypic methods for use in routine clinical microbiology practice. The present study attempts to evaluate two different methods – colistin broth disc elution and MIC detection by Vitek two in comparison to CLSI approved broth microdilution (BMD) for colistin for Enterobactarales, Pseudomonas aeruginosa , and Acinetobacter baumanii clinical isolates. Methods. Colistin susceptibility of 6013 carbapenem resistant isolates was determined by BMD, Colistin Broth Disc Elution (CBDE), and Vitek two methods and was interpreted as per CLSI guidelines. The MIC results of CBDE, Vitek two were compared with that of BMD and essential agreement (EA), categorical agreement (CA), sensitivity, specificity, very major error (VME), major error (ME) and Cohen’s kappa (CK) was calculated. The presence of any plasmid-mediated colistin resistance (mcr-1, 2, 3, 4 and 5) was evaluated in all colistin-resistant isolates by conventional polymerase chain reaction. Results. Colistin resistance was found in 778 (12.9 %) strains among the carbapenem resistant isolates. Klebsiella pneumoniae had the highest (18.9 %) colistin resistance by the BMD method. MIC of Vitek two had sensitivity ranging from 78.2–84.8% and specificity of >92 %. There were 171 VMEs and 323 MEs by Vitek two method, much more than CLSI acceptable range. The highest percentage of errors was committed for Acinetobacter baumanii (27.8 % of VME and 7.9 % ME). On the other hand, the CBDE method performed well with EA, CA, VME and ME within acceptable range for all the organisms. The sensitivity of the CBDE method compared to gold standard BMD varied from 97.5–98.8 % for different strains with a specificity of more than 97.6 %. None of the isolated colistin resistant organisms harboured mcr plasmids. Conclusion. As BMD has many technical complexities, CBDE is the best viable alternative available for countries like India. A sensitive MIC reported by Vitek two needs to be carefully considered due high propensity for VMEs particularly for Klebsiella spp.

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“…The NMIC/ID 4 panel of the BD Phoenix™ Automated Identification and Susceptibility Testing System has low accuracy in distinguishing colistin-resistant and colistin-susceptible strains [ 34 ]. Based on the identification results of the BD Phoenix™ system, the minimum inhibitory concentration was determined using the broth microdilution method to obtain a more definitive identification of colistin-resistant strains.…”

Section: Methodsmentioning

confidence: 99%

Prevalence of antimicrobial resistance and virulence genes in Klebsiella pneumoniae and Congenetic Raoultella Isolates from captive giant pandas

Sun

et al. 2023

PLoS ONE

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To study antimicrobial resistance and virulence genes of Klebsiella pneumoniae and Raoultella strains isolated from captive giant pandas. Non-duplicate fecal samples were collected from 128 giant pandas during 2017–2019. All isolated microbial strains were tested for antimicrobial drug susceptibility using BD verification panels. Four extended-spectrum β-lactamase resistance genes, nine virulence genes and six capsular serotype genes were detected using PCR. 42 K. pneumoniae and nine Raoultella strains were isolated from different giant pandas. Antibiotic resistance rates were 1.9%–23.5%, except for ampicillin, and 7.8% of the isolates were multidrug-resistant to 7–10 antibiotic classes. This is the first time that a multidrug-resistant R. ornithinolytica strain has been isolated from captive giant pandas. The blaTEM, blaCTX-M, blaSHV and blaDHA genes were detected in four MDR ESBL- K. pneumoniae strains. The rmpA, iutA, ybtS, iroN and iroB genes were positively detected in 11.7% of the isolates. Capsular serotype (K2, K5, K54 and K57) genes were all detected in four K. pneumoniae strains, and one was identified as hypervirulent. This study showed that MDR ESBL- K. pneumoniae, hypervirulent K. pneumoniae, MDR R. ornithinolytica and the colistin-resistant strain may pose risks to captive giant pandas and their keepers, and that the diversity of antibiotic resistance and virulence genes in Klebsiella and Raoultella should be monitored regularly.

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Evaluation of the BD Phoenix100 System and Colistin Broth Disk Elution Method for Antimicrobial Susceptibility Testing of Colistin Against Gram-negative Bacteria

Cited by 8 publications

References 0 publications

Detection of colistin resistance via four methods in multidrug-resistant Gram-negative rods isolated from blood cultures

Detection of colistin resistance via four methods in multidrug-resistant Gram-negative rods isolated from blood cultures

Evaluation of different methods for in vitro susceptibility testing of colistin in carbapenem resistant Gram-negative bacilli

Prevalence of antimicrobial resistance and virulence genes in Klebsiella pneumoniae and Congenetic Raoultella Isolates from captive giant pandas

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