Antimicrobial susceptibility testing of Actinomyces pyogenes: comparison of disk diffusion test and Api ATB Strep system with the agar dilution method.

The use of the disk diffusion and the Api ATB Strep system or a related technique for a few antibiotics was compared with the agar dilution method for antimicrobial susceptibility testing of 103 clinical isolates of Actinomyces pyogenes. There was complete agreement between disk diffusion and MIC in 98.8%, with minor errors, in 0.7% and with very large errors, in 0.5% of cases. The common criteria for the interpretation of zones could be kept for penicillin G, amoxicillin, methicillin, cephalothin, erythromycin, lincomycin, pristinamycin, vancomycin, rifampin, streptomycin, kanamycin, gentamicin and chloramphenicol. The proposed breakpoints for a tetracycline 30 IU disk were > or = 22 mm for susceptibility and < 22 mm for resistance. There was complete agreement between the ATB strip system and MIC in 98.3% of cases, with minor errors in 0.9% and with very large errors, in 0.8% of cases. All the dissimilarities were due to streptomycin and tetracycline and results could not be reported for these 2 antibiotics when using this system. Wells with kanamycin and gentamicin at low concentrations as well as chloramphenicol should be included by the manufacturer.