Evaluation of the Clinical Systems for Polymyxin Susceptibility Testing of Clinical Gram-Negative Bacteria in China
ObjectivesThe performance of mainstream commercial antimicrobial susceptibility testing systems on polymyxins has not been well evaluated in China. In this study, three antimicrobial susceptibility testing systems were evaluated for polymyxin B and colistin.MethodsThe MICs of 257 Gram-negative strai...
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Frontiers Media S.A.
2021-02-01
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Online Access: | https://www.frontiersin.org/articles/10.3389/fmicb.2020.610604/full |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ying Zhu Ying Zhu Peiyao Jia Peiyao Jia Menglan Zhou Jingjia Zhang Ge Zhang Wei Kang Simeng Duan Tong Wang Yingchun Xu Qiwen Yang |
spellingShingle |
Ying Zhu Ying Zhu Peiyao Jia Peiyao Jia Menglan Zhou Jingjia Zhang Ge Zhang Wei Kang Simeng Duan Tong Wang Yingchun Xu Qiwen Yang Evaluation of the Clinical Systems for Polymyxin Susceptibility Testing of Clinical Gram-Negative Bacteria in China Frontiers in Microbiology antimicrobial susceptibility testing polymyxin essential agreement category agreement very major error major error |
author_facet |
Ying Zhu Ying Zhu Peiyao Jia Peiyao Jia Menglan Zhou Jingjia Zhang Ge Zhang Wei Kang Simeng Duan Tong Wang Yingchun Xu Qiwen Yang |
author_sort |
Ying Zhu |
title |
Evaluation of the Clinical Systems for Polymyxin Susceptibility Testing of Clinical Gram-Negative Bacteria in China |
title_short |
Evaluation of the Clinical Systems for Polymyxin Susceptibility Testing of Clinical Gram-Negative Bacteria in China |
title_full |
Evaluation of the Clinical Systems for Polymyxin Susceptibility Testing of Clinical Gram-Negative Bacteria in China |
title_fullStr |
Evaluation of the Clinical Systems for Polymyxin Susceptibility Testing of Clinical Gram-Negative Bacteria in China |
title_full_unstemmed |
Evaluation of the Clinical Systems for Polymyxin Susceptibility Testing of Clinical Gram-Negative Bacteria in China |
title_sort |
evaluation of the clinical systems for polymyxin susceptibility testing of clinical gram-negative bacteria in china |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Microbiology |
issn |
1664-302X |
publishDate |
2021-02-01 |
description |
ObjectivesThe performance of mainstream commercial antimicrobial susceptibility testing systems on polymyxins has not been well evaluated in China. In this study, three antimicrobial susceptibility testing systems were evaluated for polymyxin B and colistin.MethodsThe MICs of 257 Gram-negative strains collected from clinical cases and livestock were determined and analyzed. Using Broth Microdilution as the gold standard, the performance of VITEK 2® COMPACT, PhoenixTM M50, and Bio-kont AST System were evaluated. Essential agreement (EA), category agreement (CA), very major error (VME), and major error (ME) were calculated for comparison. The results of mcr-1 positive strains were separately discussed.ResultsThe EA, CA, VME, and ME to polymyxin B for Bio-kont were 83.5, 95.6, 13.1, and 0.6%, respectively. The EAs, CAs, VMEs, and MEs to colistin were as follows: Bio-kont, 86.7%/96.5%/7.2%/1.7%; Vitek 2, 64.2%/86.8%/41.0%/0%, and Phoenix M50, 92.9%/92.9%/21.7%/0%. The performance of Bio-kont to polymyxin B and colistin for Pseudomonas spp. (EA, CA < 90%, VME > 1.5%, ME = 5.6%/10%) and Enterobacter spp. (EA, CA < 90%, VME > 1.5% and ME = 0%), Vitek to colistin for most genera, and Phoenix to colistin for Enterobacter spp. (EA, CA < 90%, VME > 1.5%, ME = 0%) were unsatisfactory compared with other genera. The performance of Bio-kont to polymyxins for Escherichia spp. and Phoenix to colistin for Citrobacter spp., Escherichia spp., and Klebsiella spp., which all met the CLSI standard, were satisfactory. When the susceptibility of mcr-1 positive E. coli was tested, Bio-kont and Phoenix M50 presented excellent performance with no category errors, while Vitek 2 performed a high VME (25.5%).ConclusionWith relatively more accurate results for polymyxin B and colistin and lower VME, Bio-kont has an advantage in polymyxin antimicrobial susceptibility testing, especially for Escherichia spp., Klebsiella spp., Citrobacter spp. and Acinetobacter spp. |
topic |
antimicrobial susceptibility testing polymyxin essential agreement category agreement very major error major error |
url |
https://www.frontiersin.org/articles/10.3389/fmicb.2020.610604/full |
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AT yingzhu evaluationoftheclinicalsystemsforpolymyxinsusceptibilitytestingofclinicalgramnegativebacteriainchina AT yingzhu evaluationoftheclinicalsystemsforpolymyxinsusceptibilitytestingofclinicalgramnegativebacteriainchina AT peiyaojia evaluationoftheclinicalsystemsforpolymyxinsusceptibilitytestingofclinicalgramnegativebacteriainchina AT peiyaojia evaluationoftheclinicalsystemsforpolymyxinsusceptibilitytestingofclinicalgramnegativebacteriainchina AT menglanzhou evaluationoftheclinicalsystemsforpolymyxinsusceptibilitytestingofclinicalgramnegativebacteriainchina AT jingjiazhang evaluationoftheclinicalsystemsforpolymyxinsusceptibilitytestingofclinicalgramnegativebacteriainchina AT gezhang evaluationoftheclinicalsystemsforpolymyxinsusceptibilitytestingofclinicalgramnegativebacteriainchina AT weikang evaluationoftheclinicalsystemsforpolymyxinsusceptibilitytestingofclinicalgramnegativebacteriainchina AT simengduan evaluationoftheclinicalsystemsforpolymyxinsusceptibilitytestingofclinicalgramnegativebacteriainchina AT tongwang evaluationoftheclinicalsystemsforpolymyxinsusceptibilitytestingofclinicalgramnegativebacteriainchina AT yingchunxu evaluationoftheclinicalsystemsforpolymyxinsusceptibilitytestingofclinicalgramnegativebacteriainchina AT qiwenyang evaluationoftheclinicalsystemsforpolymyxinsusceptibilitytestingofclinicalgramnegativebacteriainchina |
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doaj-83d4145f02c643baa25ff86ed261ebd22021-02-22T05:22:54ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2021-02-011110.3389/fmicb.2020.610604610604Evaluation of the Clinical Systems for Polymyxin Susceptibility Testing of Clinical Gram-Negative Bacteria in ChinaYing Zhu0Ying Zhu1Peiyao Jia2Peiyao Jia3Menglan Zhou4Jingjia Zhang5Ge Zhang6Wei Kang7Simeng Duan8Tong Wang9Yingchun Xu10Qiwen Yang11Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaGraduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaGraduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaObjectivesThe performance of mainstream commercial antimicrobial susceptibility testing systems on polymyxins has not been well evaluated in China. In this study, three antimicrobial susceptibility testing systems were evaluated for polymyxin B and colistin.MethodsThe MICs of 257 Gram-negative strains collected from clinical cases and livestock were determined and analyzed. Using Broth Microdilution as the gold standard, the performance of VITEK 2® COMPACT, PhoenixTM M50, and Bio-kont AST System were evaluated. Essential agreement (EA), category agreement (CA), very major error (VME), and major error (ME) were calculated for comparison. The results of mcr-1 positive strains were separately discussed.ResultsThe EA, CA, VME, and ME to polymyxin B for Bio-kont were 83.5, 95.6, 13.1, and 0.6%, respectively. The EAs, CAs, VMEs, and MEs to colistin were as follows: Bio-kont, 86.7%/96.5%/7.2%/1.7%; Vitek 2, 64.2%/86.8%/41.0%/0%, and Phoenix M50, 92.9%/92.9%/21.7%/0%. The performance of Bio-kont to polymyxin B and colistin for Pseudomonas spp. (EA, CA < 90%, VME > 1.5%, ME = 5.6%/10%) and Enterobacter spp. (EA, CA < 90%, VME > 1.5% and ME = 0%), Vitek to colistin for most genera, and Phoenix to colistin for Enterobacter spp. (EA, CA < 90%, VME > 1.5%, ME = 0%) were unsatisfactory compared with other genera. The performance of Bio-kont to polymyxins for Escherichia spp. and Phoenix to colistin for Citrobacter spp., Escherichia spp., and Klebsiella spp., which all met the CLSI standard, were satisfactory. When the susceptibility of mcr-1 positive E. coli was tested, Bio-kont and Phoenix M50 presented excellent performance with no category errors, while Vitek 2 performed a high VME (25.5%).ConclusionWith relatively more accurate results for polymyxin B and colistin and lower VME, Bio-kont has an advantage in polymyxin antimicrobial susceptibility testing, especially for Escherichia spp., Klebsiella spp., Citrobacter spp. and Acinetobacter spp.https://www.frontiersin.org/articles/10.3389/fmicb.2020.610604/fullantimicrobial susceptibility testingpolymyxinessential agreementcategory agreementvery major errormajor error |