Evaluation Report of the Colistin Broth Disk Elution Method with Acinetobacter baumannii Isolates from a Low-Resource Setting
ABSTRACT The rapid emergence of drug resistance in Acinetobacter baumannii has put forward the use of colistin as a last-resort treatment for infections with A. baumannii. Empirical colistin use without prior susceptibility testing has been one of the factors that has been promoting drug resistance...
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| Format: | Article |
| Language: | English |
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American Society for Microbiology
2022-10-01
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| Series: | Microbiology Spectrum |
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| Online Access: | https://journals.asm.org/doi/10.1128/spectrum.00871-22 |
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| author | Swati Sharma Tuhina Banerjee Rahul Garg Padma Das |
| author_facet | Swati Sharma Tuhina Banerjee Rahul Garg Padma Das |
| author_sort | Swati Sharma |
| collection | DOAJ |
| description | ABSTRACT The rapid emergence of drug resistance in Acinetobacter baumannii has put forward the use of colistin as a last-resort treatment for infections with A. baumannii. Empirical colistin use without prior susceptibility testing has been one of the factors that has been promoting drug resistance in low-resource settings. In this regard, while the advocated broth microdilution (BMD) method for colistin susceptibility testing is often considered cumbersome, the preferable colistin broth disk elution (CBDE) method has not yet been approved for A. baumannii. To prevent the underreporting of colistin susceptibility, we tested the CBDE method for A. baumannii and compared the results with those of BMD. A total of 125 A. baumannii, including 100 susceptible and 25 resistant isolates were tested via the CBDE method and compared with the standard BMD method. The essential agreement, categorical agreement, sensitivity, and specificity for CBDE were 97.6% (n = 122), 98.4% (n = 123), 100%, and 98.40%, respectively. The percentage of major error found was 1.6% (n = 2), and no very major error was found. CBDE in A. baumannii could be considered in low-resource settings. IMPORTANCE The relatively cumbersome broth microdilution (BMD) method for routine colistin susceptibility testing has not been adopted, especially in low-resource settings, often leading to the underreporting of colistin susceptibility and the promotion of the empirical use of colistin. In this regard, the much-preferred colistin broth disk elution (CBDE) method has not yet been approved for A. baumannii. We evaluated colistin susceptibility via the CBDE method, compared the results with those of the BMD method in 125 A. baumannii isolates with various profiles, and inferred that the CBDE method using 50 μL inoculum could be helpful, at least in resource-limited setups, versus not reporting susceptibility testing for colistin. |
| first_indexed | 2024-04-13T15:49:14Z |
| format | Article |
| id | doaj.art-eadb748e9e9643ee8efc0d536e838ba1 |
| institution | Directory Open Access Journal |
| issn | 2165-0497 |
| language | English |
| last_indexed | 2024-04-13T15:49:14Z |
| publishDate | 2022-10-01 |
| publisher | American Society for Microbiology |
| record_format | Article |
| series | Microbiology Spectrum |
| spelling | doaj.art-eadb748e9e9643ee8efc0d536e838ba12022-12-22T02:40:54ZengAmerican Society for MicrobiologyMicrobiology Spectrum2165-04972022-10-0110510.1128/spectrum.00871-22Evaluation Report of the Colistin Broth Disk Elution Method with Acinetobacter baumannii Isolates from a Low-Resource SettingSwati Sharma0Tuhina Banerjee1Rahul Garg2Padma Das3Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, IndiaDepartment of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, IndiaDepartment of Microbiology, All India Institute of Medical Sciences, Raipur, Chattisgarh, IndiaDepartment of Microbiology, All India Institute of Medical Sciences, Raipur, Chattisgarh, IndiaABSTRACT The rapid emergence of drug resistance in Acinetobacter baumannii has put forward the use of colistin as a last-resort treatment for infections with A. baumannii. Empirical colistin use without prior susceptibility testing has been one of the factors that has been promoting drug resistance in low-resource settings. In this regard, while the advocated broth microdilution (BMD) method for colistin susceptibility testing is often considered cumbersome, the preferable colistin broth disk elution (CBDE) method has not yet been approved for A. baumannii. To prevent the underreporting of colistin susceptibility, we tested the CBDE method for A. baumannii and compared the results with those of BMD. A total of 125 A. baumannii, including 100 susceptible and 25 resistant isolates were tested via the CBDE method and compared with the standard BMD method. The essential agreement, categorical agreement, sensitivity, and specificity for CBDE were 97.6% (n = 122), 98.4% (n = 123), 100%, and 98.40%, respectively. The percentage of major error found was 1.6% (n = 2), and no very major error was found. CBDE in A. baumannii could be considered in low-resource settings. IMPORTANCE The relatively cumbersome broth microdilution (BMD) method for routine colistin susceptibility testing has not been adopted, especially in low-resource settings, often leading to the underreporting of colistin susceptibility and the promotion of the empirical use of colistin. In this regard, the much-preferred colistin broth disk elution (CBDE) method has not yet been approved for A. baumannii. We evaluated colistin susceptibility via the CBDE method, compared the results with those of the BMD method in 125 A. baumannii isolates with various profiles, and inferred that the CBDE method using 50 μL inoculum could be helpful, at least in resource-limited setups, versus not reporting susceptibility testing for colistin.https://journals.asm.org/doi/10.1128/spectrum.00871-22CBDEBMDA. baumanniiagreement |
| spellingShingle | Swati Sharma Tuhina Banerjee Rahul Garg Padma Das Evaluation Report of the Colistin Broth Disk Elution Method with Acinetobacter baumannii Isolates from a Low-Resource Setting Microbiology Spectrum CBDE BMD A. baumannii agreement |
| title | Evaluation Report of the Colistin Broth Disk Elution Method with Acinetobacter baumannii Isolates from a Low-Resource Setting |
| title_full | Evaluation Report of the Colistin Broth Disk Elution Method with Acinetobacter baumannii Isolates from a Low-Resource Setting |
| title_fullStr | Evaluation Report of the Colistin Broth Disk Elution Method with Acinetobacter baumannii Isolates from a Low-Resource Setting |
| title_full_unstemmed | Evaluation Report of the Colistin Broth Disk Elution Method with Acinetobacter baumannii Isolates from a Low-Resource Setting |
| title_short | Evaluation Report of the Colistin Broth Disk Elution Method with Acinetobacter baumannii Isolates from a Low-Resource Setting |
| title_sort | evaluation report of the colistin broth disk elution method with acinetobacter baumannii isolates from a low resource setting |
| topic | CBDE BMD A. baumannii agreement |
| url | https://journals.asm.org/doi/10.1128/spectrum.00871-22 |
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