Comperative Evaluation of Vitek 2 and Etest Methods with the Referance Broth Microdilution for Antimicrobial Susceptibility Testing of Colistin Among Multi-Drug Resistant Gram-Negative Bacteria

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dc.contributor.authorUgrakli, Selin
dc.contributor.authorDogan, Metin
dc.date.accessioned2024-02-23T14:41:46Z
dc.date.available2024-02-23T14:41:46Z
dc.date.issued2021
dc.departmentNEÜen_US
dc.description.abstractIntroduction: Despite the increased need for colistin, especially in serious infections caused by carbapenem resistant gram-negative bacteria, problems and challenges regarding colistin susceptibility testing remain. The aim of this study was to evaluate the performance of Vitek 2, one of the commonly used automated systems, and Etest for colistin susceptibility testing compared with reference broth microdilution method (BMD). Materials and Methods: This study included 657 multi-drug resistance (MDR) Gram negative bacteria obtained from clinical samples; Negative control, Escherichia coli ATCC 25922 and Positive control, Escherichia coli NCTC 13846. The collected MDR isolates were performed colistin BMD according to ISO standard 20776-1, prospectively. Categorical agreement (CA), Very Major Error (VME), and Major Error (ME) rate were calculated. Acceptable performance was evaluated as; CA >= 90%; VME <1.5% and ME <3%. Results: Colistin resistance rates were detected by Vitek 2, Etest and BMD; 40.3%, 48.7%, 53.9%, respectively. CA rates were as fol- lows: Vitek 2 92.4% and Etest 71.9%. While the compatibility of Vitek 2 and BMD was observed (kappa value= 0.85) to be 'excellent agreement'; the agreement of Etest and BMD was found to be 'moderate' (kappa value= 0.45). Although CA varied from 85.7% to 100% for Vitek 2, it ranged 63.6% to 80% for Etest depending on bacterial species. Alarming high rates of VME were determined for Vitek 2 (14.5%) and Etest (36.5%). While MEs were 1.7% by Vitek 2; there was no false resistant isolate with Etest. Conclusion: It may be recommended for laboratories not to rely on Vitek 2 and Etest colistin susceptibility results. Additionally, colistin resistant isolates will be underestimated by reducing colistin susceptibility studies to a specific minimum inhibitory concentration (MIC). In this regard, our suggestion is that laboratories would improve their infrastructure and staff skills to apply BMD routinely.en_US
dc.identifier.doi10.5578/flora.20219720
dc.identifier.endpage527en_US
dc.identifier.issn1300-932X
dc.identifier.issue3en_US
dc.identifier.startpage518en_US
dc.identifier.urihttps://doi.org/10.5578/flora.20219720
dc.identifier.urihttps://hdl.handle.net/20.500.12452/16995
dc.identifier.volume26en_US
dc.identifier.wosWOS:000715197000020en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.language.isoenen_US
dc.publisherBilimsel Tip Yayinevien_US
dc.relation.ispartofFlora Infeksiyon Hastaliklari Ve Klinik Mikrobiyoloji Dergisien_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAntimicrobial Resistanceen_US
dc.subjectColistinen_US
dc.subjectBroth Microdilutionen_US
dc.titleComperative Evaluation of Vitek 2 and Etest Methods with the Referance Broth Microdilution for Antimicrobial Susceptibility Testing of Colistin Among Multi-Drug Resistant Gram-Negative Bacteriaen_US
dc.typeArticleen_US

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