1. Evaluation of the commercial AD fosfomycin test for susceptibility testing of multidrug-resistant Enterobacterales and Pseudomonas aeruginosa
- Author
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Alberto Antonelli, Claudia Niccolai, Marco Coppi, Romano Mattei, Giulio Camarlinghi, Maria Nardone, Gian Maria Rossolini, Chiara Vettori, Tommaso Giani, and Eva Maria Parisio
- Subjects
0301 basic medicine ,Microbiology (medical) ,Klebsiella ,Susceptibility testing ,Veterinary medicine ,biology ,business.industry ,Pseudomonas aeruginosa ,Klebsiella pneumoniae ,030106 microbiology ,General Medicine ,Fosfomycin ,biology.organism_classification ,medicine.disease_cause ,Agar dilution ,Multiple drug resistance ,03 medical and health sciences ,0302 clinical medicine ,Infectious Diseases ,Enterobacterales ,Medicine ,030212 general & internal medicine ,business ,medicine.drug - Abstract
Objectives To compare fosfomycin susceptibility testing with the commercial agar dilution (AD) test, AD Fosfomycin (Liofilchem, Roseto degli Abruzzi, Italy) and the reference AD method, using a collection of multidrug-resistant (MDR) Enterobacterales and Pseudomonas aeruginosa clinical isolates. Methods The collection included 119 carbapenemase-producing Enterobacterales, 53 Enterobacterales producing acquired AmpC-type and/or extended-spectrum β-lactamases and 38 carbapenemase-producing P. aeruginosa, including representatives of different high-risk clones. AD Fosfomycin and AD reference method (ISO 20776-1:2019) were performed starting from the same microbial suspension. Results were interpreted according to EUCAST clinical breakpoints (10.0). Essential agreement (EA), category agreement (CA) and error rates were calculated as described by the International Organization for Standardization. Results Of 172 Enterobacterales, 143 (83.1%, including 92.9% (52 of 56) of the NDM-producers and 84.2% (48 of 57) of the KPC-producers) were susceptible to fosfomycin using reference AD. A CA of 91.9% (158 of 172; 95% CI 87.1%–95.3%) and an EA of 92.5% (136 of 147; 95% CI 87.4%–96.0%), respectively, were calculated for the commercial AD Fosfomycin test, with 9.8% (14 of 143) of major errors and no very major errors (0 of 29). Overall, 86.8% (33 of 38) of P. aeruginosa showed a fosfomycin MIC ≤128 mg/L using reference AD. An EA of 84.8% (95% CI 66.3%–92.0%) was calculated for the commercial AD Fosfomycin test, with a CA of 100% (95% CI 93.6%–100%) when considering a tentative breakpoint at 128 mg/L. Conclusions AD Fosfomycin showed an overall good concordance compared with reference AD.
- Published
- 2021
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