Detection of Colistin Susceptibility in Klebsiella Pneumoniae and Acinetobacter Baumannii Strains: Method Comparison

Year 2024, , 174 - 178, 27.08.2024

İpek Koçer , Hadiye Demirbakan

https://doi.org/10.46332/aemj.1320170

Abstract

Purpose: The aim of this study was to compare the broth microdilution method (BMD)-based commercial system and colistin broth disk elution method (CBDE) for colistin susceptibility in multidrug resistant Gram-negative bacteria.

Materials and methods: 112 K. pneumoniae and 62 A. baumannii isolates which were isolated from various clinical specimens between March 2020 and June 2022 were included in the study. The colistin susceptibilities of the strains were compared with BMD-based commercial system and CBDE methods.

Results: For K. pneumoniae isolates, a very good agreement was found between the results of the KSDE test and those of the commercially available SMD-based kit (κ=0.88). However, for A. baumannii isolates, there was a negligible level of agreement between the results of the KSDE test and the commercially available SMD-based kit (κ=0.11).

Conclusions: The CBDE method is highly compatible in determining the colistin susceptibility of Klebsiella species. The low level of agreement in Acinetobacter isolates indicates that new methods that can be applied in the routine laboratory as an alternative to the gold standard BMD method, are needed.

Keywords

antibiotic sensitivity, broth microdilution, colistin, disk elution

Project Number

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Klebsiella Pneumoniae ve Acinetobacter Baumannii Suşlarında Kolistin Duyarlılığının Saptanması: Yöntem Karşılaştırması

Abstract

Amaç: Bu çalışma ile çok ilaca dirençli Gram negatif bakterilerde kolistin duyarlılığı için sıvı mikrodilüsyon (SMD) temelli ticari sistem ile kolistin sıvı disk elüsyon (KSDE) yöntemlerinin karşılaştırılması amaçlanmıştır.

Araçlar ve Yöntem: Mart 2020 - Haziran 2022 tarihleri arasında çeşitli klinik örneklerden izole edilen 112 K. pneumoniae ve 62 A. baumannii izolatı çalışmaya alınmıştır. Suşların kolistin duyarlılıkları SMD temelli ticari sistem ve KSDE yöntemleri ile karşılaştırılmıştır.

Bulgular: K. pneumoniae izolatlarının KSDE test sonuçları ile SMD temelli ticari kit sonuçları arasında çok iyi uyum bulunmuştur (κ=0.88). A. baumannii izolatlarının KSDE test sonuçları ile SMD temelli ticari kit sonuçları karşılaştırıldığında ise önemsiz düzeyde uyum bulunmuştur (κ=0.11).

Sonuç: Klebsiella izolatlarında KSDE yönteminin kolistin duyarlılığının belirlenmesinde uyumu yüksektir. Acinetobacter izolatlarında ise uyum düzeyinin düşük olması altın standart SMD yöntemine alternatif, rutin laboratuvarda uygulanabilir yöntemlere ihtiyaç olduğunu göstermektedir.

Keywords

antibiyotik duyarlılık, disk elüsyon, kolistin, sıvı mikrodilüsyon

Supporting Institution

yok

Project Number

yok

Thanks

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References

• 1. Biswas S, Brunel JM, Dubus JC, Reynaud-Gaubert M, Rolain JM. Colistin: an update on the antibiotic of the 21st century. Expert Rev Anti Infect Ther. 2012;10(8):917-934.
• 2. Binsker U, Käsbohrer A, Hammerl JA. Global colistin use: a review of the emergence of resistant Enterobacterales and the impact on their genetic basis. FEMS Microbiol. Rev. 2021;46(1):49.
• 3. Uzairue LI, Rabaan AA, Adewumi FA, et al. Global Prevalence of Colistin Resistance in Klebsiella pneumoniae from Bloodstream Infection: A Systematic Review and Meta-Analysis. Pathogens. 2022;11(10): 1092.
• 4. European Committee on Antimicrobial Susceptibility Testing.Recommendations for MIC determination of colistin (polymyxin E) as recommended by the joint CLSI-EUCAST Polymyxin Breakpoints Working Group. 2016.
• 5. The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters.
• 6. Simner PJ, Bergman Y, Trejo M, et al. Two-Site Evaluation of the Colistin Broth Disk Elution Test To Determine Colistin In Vitro Activity against Gram-Negative Bacilli. J Clin Microbiol. 2019;57(2):10-1128.
• 7. European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. (EUCAST) Version7.1. http://www.eucast.org/ast_of_bacteria/previous_versions_of_documents. Erişim tarihi 10 Temmuz, 2023.
• 8. Landis JR, Koch GG. The Measurement of Observer Agreement for Categorical Data. Biometrics. 1977;33 (1):159-174.
• 9. Akobeng AK. Understanding randomised controlled trials. Arch Dis Child. 2005;90(8):840-844.
• 10. Rojas LJ, Salim M, Cober E, et al. Colistin Resistance in Carbapenem-Resistant Klebsiella pneumoniae: Laboratory Detection and Impact on Mortality. Clin Infect Dis. 2017;64(6):711-718.
• 11. Ezadi F, Ardebili A, Mirnejad R. Antimicrobial Susceptibility Testing for Polymyxins: Challenges, Issues, and Recommendations. J Clin Microbiol. 2019;57(4):10-1128.
• 12. Bell DT, Bergman Y, Kazmi AQ, Lewis S, Tamma PD, Simner PJ. A Novel Phenotypic Method To Screen for Plasmid-Mediated Colistin Resistance among Enterobacteriales. J Clin Microbiol. 2019; 57(5):10-1128.
• 13. Koyuncu Özyurt Ö, Özhak B, Öğünç D, et al. Evaluation of the BD Phoenix100 System and Colistin Broth Disk Elution Method for Antimicrobial Susceptibility Testing of Colistin Against Gram-negative Bacteria. Mikrobiyol Bul. 2019;53(3):254-261.
• 14. Humphries RM, Green DA, Schuetz AN, et al. Multicenter Evaluation of Colistin Broth Disk Elution and Colistin Agar Test: a Report from the Clinical and Laboratory Standards Institute. J Clin Microbiol. 2019;57(11):10-1128.
• 15. Főldes A, Székely E, Voidăzan ST, Dobreanu M. Comparison of Six Phenotypic Assays with Reference Methods for Assessing Colistin Resistance in Clinical Isolates of Carbapenemase-Producing Enterobacterales: Challenges and Opportunities. Antibiotics. 2022;11(3):337.
• 16. Butt T, Butt A, Yasmin S, Taj S, Tariq N, Bano S. Antibiotic Disk Elution Method to Determine the Colistin Susceptibility against Enterobacterales and Non-fermenter Bacteria. J Coll Physicians Surg Pak. 2022;32(6):820-822.
• 17. Sarıkaya A, Mumcuoğlu İ, Baran I, Aksoy A, Dinç B. Comparision of Colistin Broth Disc Elution, Rapid Resapolymyxin NP and Broth Microdilution Methods in Determining Colistin Sensitivity in Acinetobacter, Pseudomonas and Enterobacterales species. Mikrobiyol Bul. 2022;56(3):404-415.