Comparative Evaluation of Vitek 2 and Etest versus Broth Microdilution for Ceftazidime/Avibactam and Ceftolozane/Tazobactam Susceptibility Testing of <i>Enterobacterales</i> and <i>Pseudomonas aeruginosa</i>
Ceftazidime/avibactam (CZA) and ceftolozane/tazobactam (C/T) are novel antibiotics with activity against multidrug-resistant Gram-negative pathogens. Nevertheless, resistance to both agents has been reported emphasizing the need for accurate and widely accessible susceptibility testing. In the prese...
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| Format: | Article |
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MDPI AG
2022-06-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/11/7/865 |
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| author | Arhodoula Papadomanolaki Maria Siopi Polyxeni Karakosta Sophia Vourli Spyros Pournaras |
| author_facet | Arhodoula Papadomanolaki Maria Siopi Polyxeni Karakosta Sophia Vourli Spyros Pournaras |
| author_sort | Arhodoula Papadomanolaki |
| collection | DOAJ |
| description | Ceftazidime/avibactam (CZA) and ceftolozane/tazobactam (C/T) are novel antibiotics with activity against multidrug-resistant Gram-negative pathogens. Nevertheless, resistance to both agents has been reported emphasizing the need for accurate and widely accessible susceptibility testing. In the present study, Vitek 2 and Etest CAZ and C/T MIC results for 100 non-repetitive clinical isolates (83 <i>Enterobacterales</i> and 17 <i>P. aeruginosa</i>, whereof 69 challenge isolates) were compared to the standard broth microdilution (BMD) method. EUCAST breakpoints were used for assessing the categorical (CA) and essential (EA) agreement between the methods along with the corresponding error rates. The Vitek 2 performance was comparable to that of BMD for testing both antimicrobial agents exceeding the ISO requirements (CA 98–99%, EA 96–100%, major errors (MEs) 0–1%, very major error (VMEs) 1%). Likewise, the Etest provided accurate results for CZA and C/T testing against <i>Enterobacterales</i> and <i>P. aeruginosa</i>, respectively (CA 100%, EA 97–100%, MEs 0%, VMEs 0%). On the contrary, EA of 85% and 6% VME rate were found for CZA Etest and <i>P. aeruginosa</i>. Overall, Vitek 2 measurements of CZA and C/T susceptibility correlated closely with the reference BMD, indicating that it can represent a suitable alternative to BMD for susceptibility testing of <i>Enterobacterales</i> and <i>P. aeruginosa</i>. The Etest did not fulfill the ISO performance criteria of EA and VME for CZA and <i>P. aeruginosa</i>. Further studies are needed to assess whether the Etest allows a reliable assessment of CZA and C/T EUCAST MICs. |
| first_indexed | 2024-03-09T12:21:16Z |
| format | Article |
| id | doaj.art-dd56b919f26b4cecadf9101edbad1fcc |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T12:21:16Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-dd56b919f26b4cecadf9101edbad1fcc2023-11-30T22:40:54ZengMDPI AGAntibiotics2079-63822022-06-0111786510.3390/antibiotics11070865Comparative Evaluation of Vitek 2 and Etest versus Broth Microdilution for Ceftazidime/Avibactam and Ceftolozane/Tazobactam Susceptibility Testing of <i>Enterobacterales</i> and <i>Pseudomonas aeruginosa</i>Arhodoula Papadomanolaki0Maria Siopi1Polyxeni Karakosta2Sophia Vourli3Spyros Pournaras4Laboratory of Clinical Microbiology, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, GreeceLaboratory of Clinical Microbiology, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, GreeceLaboratory of Clinical Microbiology, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, GreeceLaboratory of Clinical Microbiology, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, GreeceLaboratory of Clinical Microbiology, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, GreeceCeftazidime/avibactam (CZA) and ceftolozane/tazobactam (C/T) are novel antibiotics with activity against multidrug-resistant Gram-negative pathogens. Nevertheless, resistance to both agents has been reported emphasizing the need for accurate and widely accessible susceptibility testing. In the present study, Vitek 2 and Etest CAZ and C/T MIC results for 100 non-repetitive clinical isolates (83 <i>Enterobacterales</i> and 17 <i>P. aeruginosa</i>, whereof 69 challenge isolates) were compared to the standard broth microdilution (BMD) method. EUCAST breakpoints were used for assessing the categorical (CA) and essential (EA) agreement between the methods along with the corresponding error rates. The Vitek 2 performance was comparable to that of BMD for testing both antimicrobial agents exceeding the ISO requirements (CA 98–99%, EA 96–100%, major errors (MEs) 0–1%, very major error (VMEs) 1%). Likewise, the Etest provided accurate results for CZA and C/T testing against <i>Enterobacterales</i> and <i>P. aeruginosa</i>, respectively (CA 100%, EA 97–100%, MEs 0%, VMEs 0%). On the contrary, EA of 85% and 6% VME rate were found for CZA Etest and <i>P. aeruginosa</i>. Overall, Vitek 2 measurements of CZA and C/T susceptibility correlated closely with the reference BMD, indicating that it can represent a suitable alternative to BMD for susceptibility testing of <i>Enterobacterales</i> and <i>P. aeruginosa</i>. The Etest did not fulfill the ISO performance criteria of EA and VME for CZA and <i>P. aeruginosa</i>. Further studies are needed to assess whether the Etest allows a reliable assessment of CZA and C/T EUCAST MICs.https://www.mdpi.com/2079-6382/11/7/865challenge isolatescarbapenem-resistant <i>Enterobacterales</i>carbapenem-resistant <i>Pseudomonas</i>antimicrobial susceptibility testingBMDmajor error |
| spellingShingle | Arhodoula Papadomanolaki Maria Siopi Polyxeni Karakosta Sophia Vourli Spyros Pournaras Comparative Evaluation of Vitek 2 and Etest versus Broth Microdilution for Ceftazidime/Avibactam and Ceftolozane/Tazobactam Susceptibility Testing of <i>Enterobacterales</i> and <i>Pseudomonas aeruginosa</i> Antibiotics challenge isolates carbapenem-resistant <i>Enterobacterales</i> carbapenem-resistant <i>Pseudomonas</i> antimicrobial susceptibility testing BMD major error |
| title | Comparative Evaluation of Vitek 2 and Etest versus Broth Microdilution for Ceftazidime/Avibactam and Ceftolozane/Tazobactam Susceptibility Testing of <i>Enterobacterales</i> and <i>Pseudomonas aeruginosa</i> |
| title_full | Comparative Evaluation of Vitek 2 and Etest versus Broth Microdilution for Ceftazidime/Avibactam and Ceftolozane/Tazobactam Susceptibility Testing of <i>Enterobacterales</i> and <i>Pseudomonas aeruginosa</i> |
| title_fullStr | Comparative Evaluation of Vitek 2 and Etest versus Broth Microdilution for Ceftazidime/Avibactam and Ceftolozane/Tazobactam Susceptibility Testing of <i>Enterobacterales</i> and <i>Pseudomonas aeruginosa</i> |
| title_full_unstemmed | Comparative Evaluation of Vitek 2 and Etest versus Broth Microdilution for Ceftazidime/Avibactam and Ceftolozane/Tazobactam Susceptibility Testing of <i>Enterobacterales</i> and <i>Pseudomonas aeruginosa</i> |
| title_short | Comparative Evaluation of Vitek 2 and Etest versus Broth Microdilution for Ceftazidime/Avibactam and Ceftolozane/Tazobactam Susceptibility Testing of <i>Enterobacterales</i> and <i>Pseudomonas aeruginosa</i> |
| title_sort | comparative evaluation of vitek 2 and etest versus broth microdilution for ceftazidime avibactam and ceftolozane tazobactam susceptibility testing of i enterobacterales i and i pseudomonas aeruginosa i |
| topic | challenge isolates carbapenem-resistant <i>Enterobacterales</i> carbapenem-resistant <i>Pseudomonas</i> antimicrobial susceptibility testing BMD major error |
| url | https://www.mdpi.com/2079-6382/11/7/865 |
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