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Reliability of Disk Diffusion Test Results for the Antimicrobial Susceptibility Testing of Nosocomial Gram-Positive Microorganisms: Is E-Test Method Better?



Khalili H1 ; Soltani R2 ; Negahban S3 ; Abdollahi A4 ; Gholami K4
Authors
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Authors Affiliations
  1. 1. Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Clinical Pharmacy, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Microbiology Laboratory, Imam Khomeini Hospital, Tehran, Iran
  4. 4. Department of Pathology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Source: Iranian Journal of Pharmaceutical Research Published:2012

Abstract

Disk diffusion test is the usual applicable method for assessing the antimicrobial susceptibility pattern in most institutions and hospitals. The aim of this study was to determine the reliability of resistant-reported results of disk diffusion test for 6 routinely used antibiotics against Gram-positive microorganisms of nosocomial origin, using E-test method. Over a 1-year period, clinical specimens (e.g. blood, tracheal secretions, wound secretions, urine, etc.) were obtained from hospitalized patients with defined nosocomial infection and were cultured. Isolated Gram-positive bacteria underwent disk diffusion test for cephalothin, oxacillin, clindamycin, ciprofoxacin, vancomycin, teicoplanin (only for Enterococci), and meropenem antibiotics. E-test method was performed for all isolates resistant or intermediately sensitive to the disks of any mentioned antibiotics. Data showed compatible results of disk diffusion test with the results of E-test method for cephalothin, oxacillin, ciprofoxacin, vancomycin, and teicoplanin. None of ciprofoxacin-and vancomycin-resistant isolates in disk diffusion test showed sensitivity in E-test method. Significant differences between the results of disk diffusion and E-test methods were observed for clindamycin and meropenem against S.aureus (p = 0.01 and 0.04, respectively) and Enterococcus spp (p = 0.03 and 0.02, respectively). In order to increase the reliability of antimicrobial susceptibility results, it is recommended to perform E-test for nosocomial Gram-positive microorganisms that show antibiotic resistance by disk diffusion test and it is more important for clindamycin and meropenem. © 2012 by School of Pharmacy.
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