Περίληψη:
In order to compare the prevalence of antibiotic resistance in different
geographical areas, it is necessary to ensure agreement between
laboratories on the assignment of strains to ‘susceptible’ and
‘resistant’ categories. An international quality assessment was
performed to investigate the performance of susceptibility testing of
Klebsiella spp. Ninety-five strains of klebsiellae were selected from
clinical isolates at the London Hospital Medical College (LHMC). These
included strains with a diversity of susceptibility profiles to
amoxycillin/clavulanate, piperacillin, ceftazidime, cefuroxime,
ciprofloxacin, gentamicin and trimethoprim. The strains were sent to 13
participating laboratories in Europe and the USA and laboratories were
asked to test the susceptibility of these strains to these antibiotics
by their usual methods. They were also asked to provide details of the
method used to test susceptibility. Several different standard
recommended testing methods were used. Reporting of susceptibilities was
generally accurate, but a number of anomalies were noted. Discrepancies
of reporting between the LHMC and the participating laboratories was
more marked for resistant strains, particularly in the detection of
resistance to cefuroxime and ciprofloxacin, as well as the assignment of
susceptibility and resistance to piperacillin and
amoxycillin/clavulanate. Some discrepancies could be attributed to the
use of different breakpoints, leading to differing assignment of
susceptibility. Methodological variations including disc content,
inoculum and failure to measure and interpret zone sizes consistently
also led to anomalies. This quality assessment programme has helped to
identify problems in susceptibility testing which should be investigated
further.
Συγγραφείς:
Jenks, PJ
Akalin, E
Bergan, T
Dornbusch, K
Howard, AJ
and Hryniewicz, W
Jones, JRN
King, A
McLaughlin, JC and
Ozkuyumcu, C
Percival, A
Phillips, I
Reeves, DS
Spencer,
R
Vatopoulos, AC
Warren, R
Williams, JD
