AI Article Synopsis
- The study evaluates two alternative methods (disk approximation and MIC:MIC ratio) for testing antibiotic combinations against multidrug-resistant bacteria, compared to the gold standard, the time-kill assay.
- Results showed varying levels of agreement between the methods, with the disk approximation method showing a range of 20-93% agreement with time-kill assays.
- The findings suggest that these simpler methods could be useful for clinical microbiology laboratories in assessing antibiotic synergy, particularly for certain resistant strains.
Article Abstract
Background: The use of combined antibiotic therapy has become an option for infections caused by multidrug-resistant (MDR) bacteria. The time-kill (TK) assay is considered the gold standard method for the evaluation of in vitro synergy, but it is a time-consuming and expensive method. The purpose of this study was to evaluate two methods for testing in vitro antimicrobial combinations: the disk diffusion method through disk approximation (DA) and the agar gradient diffusion method via the MIC:MIC ratio. The TK assay was included as the gold standard. MDR Gram-negative clinical isolates (n = 62; 28 Pseudomonas aeruginosa, 20 Acinetobacter baumannii, and 14 Serratia marcescens) were submitted to TK, DA, and MIC:MIC ratio synergy methods.
Results: Overall, the agreement between the DA and TK assays ranged from 20 to 93%. The isolates of A. baumannii showed variable results of synergism according to TK, and the calculated agreement was statistically significant in this species against fosfomycin with meropenem including colistin-resistant isolates. The MIC:MIC ratiometric agreed from 35 to 71% with TK assays. The kappa test showed good agreement for the combination of colistin with amikacin (K = 0.58; P = 0.04) among the colistin-resistant A. baumannii isolates.
Conclusions: The DA and MIC:MIC ratiometric methods are easier to perform and might be a more viable tool for clinical microbiology laboratories.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161189 | PMC |
| http://dx.doi.org/10.1186/s12866-020-01756-0 | DOI Listing |
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