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Comparative Evaluation of Colistin Susceptibility Testing Using Agar Dilution and Broth Microdilution in Multidrug-resistant and Extensively Drug-resistant Gram-Negative Isolates

Article

Last updated: 05 Jan 2025

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Subjects

-

Tags

Clinical microbiology

Abstract

Background: Emergence of multidrug resistance (MDR) and extensively drug resistance (XDR) among Gram-negative bacteria has obliged the clinical re-use of old antimicrobial agents, such as colistin. The increase in the use of colistin has necessitated reliable, and accurate methods for in vitro antimicrobial susceptibility testing to allow proper antimicrobial therapy. Up till now the most commonly used method in laboratories for colistin susceptibility testing is the disk diffusion test which is considered unreliable. Objectives: This study aimed to evaluate and compare two methods for colistin susceptibility testing using agar dilution and broth microdilution among MDR and XDR Gram-negative isolates. Methodology: This study included 62 Gram-negative isolates (38 MDR and 24 XDR) obtained from the Medical Microbiology and Immunology Department, Cairo University, Egypt. Colistin susceptibility was tested for these isolates by agar dilution and broth microdilution methods. Results:  Our study revealed a significant statistical difference between colistin MIC by using broth microdilution and the agar dilution method. In comparison to broth microdilution, the agar dilution method had 100% sensitivity, 85.88 % specificity, 25% positive predictive value, 100% negative predictive value and 86.21% accuracy. Conclusions:  The agar dilution method is unreliable for the detection of colistin resistance. Therefore, we could depend on colistin susceptibility testing by using standard broth microdilution even in case of limited resources. This accurate susceptibility testing may help us to maintain the therapeutic usefulness of colistin until newer treatment choices are available.

DOI

10.21608/ejmm.2023.310119

Keywords

Gram-negative bacteria, MDR, XDR, Colistin, Broth microdilution, agar dilution

Authors

First Name

Abeer

Last Name

Abu-El-Azayem

MiddleName

K.

Affiliation

Department of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, Cairo, Egypt

Email

abeerkhaledazayem@gmail.com

City

Cairo

Orcid

-

First Name

Reham

Last Name

Dwedar

MiddleName

A.

Affiliation

Department of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, Cairo, Egypt

Email

rehamdwedar@gmail.com

City

-

Orcid

-

First Name

Nihal

Last Name

Nashaat

MiddleName

-

Affiliation

Department of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, Cairo, Egypt

Email

nihalnashaat1@gmail.com

City

Cairo

Orcid

-

First Name

Rania

Last Name

Shash

MiddleName

Y.

Affiliation

Department of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, Cairo, Egypt

Email

raniayahiashash@cu.edu.eg

City

-

Orcid

0000-0002-6039-3737

Volume

32

Article Issue

3

Related Issue

41216

Issue Date

2023-07-01

Receive Date

2023-07-29

Publish Date

2023-07-01

Page Start

109

Page End

115

Print ISSN

1110-2179

Online ISSN

2537-0979

Article File

EJMM_Volume 32_Issue 3_Pages 109-115.pdf

PDF . 307.1kB

Link

https://ejmm.journals.ekb.eg/article_310119.html

Detail API

https://ejmm.journals.ekb.eg/service?article_code=310119

Order

310,119

Type

New and original researches in the field of Microbiology.

Type Code

2,038

Publication Type

Journal

Publication Title

Egyptian Journal of Medical Microbiology

Publication Link

https://ejmm.journals.ekb.eg/

MainTitle

Comparative Evaluation of Colistin Susceptibility Testing Using Agar Dilution and Broth Microdilution in Multidrug-resistant and Extensively Drug-resistant Gram-Negative Isolates

Details

Type

Article

Created At

28 Dec 2024