Reliability of various antimicrobial susceptibility testing methods for piperacillin/tazobactam in challenging Escherichia coli isolates

Objective: Piperacillin/tazobactam antimicrobial susceptibility testing (AST) against Enterobacterales can be challenging. The aim of this study was to assess the reproducibility of various automated (VITEK 2) and nonautomated AST methods (broth microdilution (BMD), minimum inhibitory concentration...

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Main Authors: Faruk Demirocak, Diana Langerak, Erlangga Yusuf
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Journal of Global Antimicrobial Resistance
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213716525000050
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author Faruk Demirocak
Diana Langerak
Erlangga Yusuf
author_facet Faruk Demirocak
Diana Langerak
Erlangga Yusuf
author_sort Faruk Demirocak
collection DOAJ
description Objective: Piperacillin/tazobactam antimicrobial susceptibility testing (AST) against Enterobacterales can be challenging. The aim of this study was to assess the reproducibility of various automated (VITEK 2) and nonautomated AST methods (broth microdilution (BMD), minimum inhibitory concentration (MIC) test strip, and disk diffusion) for piperacillin/tazobactam in ‘challenging’ E. coli isolates. Methods: We performed 20 repeated ASTs for seven clinical E. coli isolates: Two resistant to piperacillin/tazobactam but susceptible to amoxicillin/clavulanic acid, four isolates with various β-lactamase coding genes (two blaTEM-1, one blaOXA-1, and one with plasmidal blaampC), and one isolate where VITEK 2 initially could not produce MIC measurements for piperacillin/tazobactam (i.e. no results generated). Results: Upon repetition, the same MIC as the mode value (i.e. the most frequent MIC value of each AST method) was found between 21% and 87% (BMD), 46% and 100% (VITEK 2), and 48% and 100% (gradient test) of the repetitions. The range of essential agreement percentage (i.e. ±1 doubling dilution from this mode value) was 53–100% (BMD), 63–100% (VITEK 2), and 100% (gradient test). Percent categorical agreement (same susceptible of resistant category using EUCAST breakpoint v. 14.0) was 71–100% (BMD), 85–92% (VITEK 2), 76–100% (gradient test) and 100% (disk diffusion). Conclusions: : In conclusion, this study provides insight on the reliability of AST results for piperacillin/tazobactam in challenging E. coli isolates. While the results indicate that most methods are generally reproducible, certain isolates may present inconsistent MIC results.
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spelling doaj-art-58660989b2764da48d388f7fcf4a48c22025-08-20T03:05:41ZengElsevierJournal of Global Antimicrobial Resistance2213-71652025-03-014121121510.1016/j.jgar.2024.12.028Reliability of various antimicrobial susceptibility testing methods for piperacillin/tazobactam in challenging Escherichia coli isolatesFaruk Demirocak0Diana Langerak1Erlangga Yusuf2Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The NetherlandsDepartment of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The NetherlandsCorresponding author. Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Dr. Molenwaterplein 40, 3015GD, Rotterdam, The Netherlands.; Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The NetherlandsObjective: Piperacillin/tazobactam antimicrobial susceptibility testing (AST) against Enterobacterales can be challenging. The aim of this study was to assess the reproducibility of various automated (VITEK 2) and nonautomated AST methods (broth microdilution (BMD), minimum inhibitory concentration (MIC) test strip, and disk diffusion) for piperacillin/tazobactam in ‘challenging’ E. coli isolates. Methods: We performed 20 repeated ASTs for seven clinical E. coli isolates: Two resistant to piperacillin/tazobactam but susceptible to amoxicillin/clavulanic acid, four isolates with various β-lactamase coding genes (two blaTEM-1, one blaOXA-1, and one with plasmidal blaampC), and one isolate where VITEK 2 initially could not produce MIC measurements for piperacillin/tazobactam (i.e. no results generated). Results: Upon repetition, the same MIC as the mode value (i.e. the most frequent MIC value of each AST method) was found between 21% and 87% (BMD), 46% and 100% (VITEK 2), and 48% and 100% (gradient test) of the repetitions. The range of essential agreement percentage (i.e. ±1 doubling dilution from this mode value) was 53–100% (BMD), 63–100% (VITEK 2), and 100% (gradient test). Percent categorical agreement (same susceptible of resistant category using EUCAST breakpoint v. 14.0) was 71–100% (BMD), 85–92% (VITEK 2), 76–100% (gradient test) and 100% (disk diffusion). Conclusions: : In conclusion, this study provides insight on the reliability of AST results for piperacillin/tazobactam in challenging E. coli isolates. While the results indicate that most methods are generally reproducible, certain isolates may present inconsistent MIC results.http://www.sciencedirect.com/science/article/pii/S2213716525000050Antimicrobial susceptibility testReproducibilityMinimum inhibitory concentrationVITEKPiperacillin/tazobactamEscherichia coli
spellingShingle Faruk Demirocak
Diana Langerak
Erlangga Yusuf
Reliability of various antimicrobial susceptibility testing methods for piperacillin/tazobactam in challenging Escherichia coli isolates
Journal of Global Antimicrobial Resistance
Antimicrobial susceptibility test
Reproducibility
Minimum inhibitory concentration
VITEK
Piperacillin/tazobactam
Escherichia coli
title Reliability of various antimicrobial susceptibility testing methods for piperacillin/tazobactam in challenging Escherichia coli isolates
title_full Reliability of various antimicrobial susceptibility testing methods for piperacillin/tazobactam in challenging Escherichia coli isolates
title_fullStr Reliability of various antimicrobial susceptibility testing methods for piperacillin/tazobactam in challenging Escherichia coli isolates
title_full_unstemmed Reliability of various antimicrobial susceptibility testing methods for piperacillin/tazobactam in challenging Escherichia coli isolates
title_short Reliability of various antimicrobial susceptibility testing methods for piperacillin/tazobactam in challenging Escherichia coli isolates
title_sort reliability of various antimicrobial susceptibility testing methods for piperacillin tazobactam in challenging escherichia coli isolates
topic Antimicrobial susceptibility test
Reproducibility
Minimum inhibitory concentration
VITEK
Piperacillin/tazobactam
Escherichia coli
url http://www.sciencedirect.com/science/article/pii/S2213716525000050
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