Multicenter evaluation of the etest gradient diffusion method for ceftolozane-tazobactam susceptibility testing of enterobacteriaceae and pseudomonas aeruginosa

Adam L. Bailey, Tom Armstrong, Hari Prakash Dwivedi, Gerald Denys, Janet Hindler, Shelley Campeau, Maria Traczewski, Romney Humphries, Carey Ann D. Burnham

Research output: Contribution to journalArticle

Abstract

Ceftolozane-tazobactam (C/T) is a novel beta-lactam-beta-lactamase inhibitor combination antibiotic approved by the U.S. Food and Drug Administration in 2014 for the treatment of complicated intra-abdominal infections (in combination with metronidazole) and complicated urinary tract infections. In this study, we evaluated the performance of the C/T Etest, a gradient diffusion method. C/T Etest was compared to broth microdilution (BMD) for 51 Enterobacteriaceae challenge isolates and 39 Pseudomonas aeruginosa challenge isolates at three clinical sites. Essential agreement (EA) between the methods ranged from 47 to 49/51 (92.2 to 96.1%) for the Enterobacteriaceae, and categorical agreement (CA) ranged from 49 to 51/51 (96.1 to 100.0%). EA and CA for P. aeruginosa were 100% at all sites. The C/T Etest was also compared to BMD for susceptibility testing on 966 clinical isolates (793 Enterobacteriaceae, including 167 Klebsiella pneumoniae and 159 Escherichia coli isolates, in addition to 173 P. aeruginosa isolates) collected at four clinical sites. EA between Etest and BMD was 96.9% for Enterobacteriaceae isolates and 98.8% for P. aeruginosa isolates. Within the Enterobacteriaceae, isolates from each species examined had 96% CA. For the clinical isolates, no very major errors were identified but two major errors were found (one for K. pneumoniae and one for Providencia rettgeri). By BMD, 47.0% of Enterobacteriaceae and 46.2% of P. aeruginosa challenge strains were nonsusceptible to C/T by CLSI breakpoint criteria; 8.2% of clinical Enterobacteriaceae isolates and 12.1% of clinical P. aeruginosa isolates were nonsusceptible to C/T by CLSI breakpoint criteria. In conclusion, Etest is accurate and reproducible for C/T susceptibility testing of Enterobacteriaceae and P. aeruginosa.

Original languageEnglish (US)
Article numbere00717
JournalJournal of clinical microbiology
Volume56
Issue number9
DOIs
StatePublished - Sep 1 2018

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Disk Diffusion Antimicrobial Tests
Enterobacteriaceae
Pseudomonas aeruginosa
Klebsiella pneumoniae
Providencia
Intraabdominal Infections
tazobactam drug combination ceftolozane
Metronidazole
beta-Lactams
United States Food and Drug Administration
Urinary Tract Infections
Escherichia coli
Anti-Bacterial Agents

Keywords

  • Antimicrobial susceptibility testing
  • Ceftolozane-tazobactam
  • Enterobacteriaceae
  • Etest
  • Gradient diffusion method
  • Pseudomonas aeruginosa

ASJC Scopus subject areas

  • Microbiology (medical)

Cite this

Multicenter evaluation of the etest gradient diffusion method for ceftolozane-tazobactam susceptibility testing of enterobacteriaceae and pseudomonas aeruginosa. / Bailey, Adam L.; Armstrong, Tom; Dwivedi, Hari Prakash; Denys, Gerald; Hindler, Janet; Campeau, Shelley; Traczewski, Maria; Humphries, Romney; Burnham, Carey Ann D.

In: Journal of clinical microbiology, Vol. 56, No. 9, e00717, 01.09.2018.

Research output: Contribution to journalArticle

Bailey, Adam L. ; Armstrong, Tom ; Dwivedi, Hari Prakash ; Denys, Gerald ; Hindler, Janet ; Campeau, Shelley ; Traczewski, Maria ; Humphries, Romney ; Burnham, Carey Ann D. / Multicenter evaluation of the etest gradient diffusion method for ceftolozane-tazobactam susceptibility testing of enterobacteriaceae and pseudomonas aeruginosa. In: Journal of clinical microbiology. 2018 ; Vol. 56, No. 9.
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abstract = "Ceftolozane-tazobactam (C/T) is a novel beta-lactam-beta-lactamase inhibitor combination antibiotic approved by the U.S. Food and Drug Administration in 2014 for the treatment of complicated intra-abdominal infections (in combination with metronidazole) and complicated urinary tract infections. In this study, we evaluated the performance of the C/T Etest, a gradient diffusion method. C/T Etest was compared to broth microdilution (BMD) for 51 Enterobacteriaceae challenge isolates and 39 Pseudomonas aeruginosa challenge isolates at three clinical sites. Essential agreement (EA) between the methods ranged from 47 to 49/51 (92.2 to 96.1{\%}) for the Enterobacteriaceae, and categorical agreement (CA) ranged from 49 to 51/51 (96.1 to 100.0{\%}). EA and CA for P. aeruginosa were 100{\%} at all sites. The C/T Etest was also compared to BMD for susceptibility testing on 966 clinical isolates (793 Enterobacteriaceae, including 167 Klebsiella pneumoniae and 159 Escherichia coli isolates, in addition to 173 P. aeruginosa isolates) collected at four clinical sites. EA between Etest and BMD was 96.9{\%} for Enterobacteriaceae isolates and 98.8{\%} for P. aeruginosa isolates. Within the Enterobacteriaceae, isolates from each species examined had 96{\%} CA. For the clinical isolates, no very major errors were identified but two major errors were found (one for K. pneumoniae and one for Providencia rettgeri). By BMD, 47.0{\%} of Enterobacteriaceae and 46.2{\%} of P. aeruginosa challenge strains were nonsusceptible to C/T by CLSI breakpoint criteria; 8.2{\%} of clinical Enterobacteriaceae isolates and 12.1{\%} of clinical P. aeruginosa isolates were nonsusceptible to C/T by CLSI breakpoint criteria. In conclusion, Etest is accurate and reproducible for C/T susceptibility testing of Enterobacteriaceae and P. aeruginosa.",
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AU - Denys, Gerald

AU - Hindler, Janet

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