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Shortening the incubation time for the combination disk diffusion extended-spectrum β-lactamase (ESBL) confirmation test: how far can we go?
- Source :
- International Journal of Antimicrobial Agents, 50(3), 473-476. Elsevier
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- The combination disk diffusion extended-spectrum β-lactamase (ESBL) confirmation test (CDT) is used for the confirmation of ESBL production in Enterobacteriaceae and usually takes 16–20 h to results. In this study, we searched for the shortest possible incubation time without a reduction in reliability. A total of 125 ESBL screening-positive isolates were subjected to CDT and were molecularly characterised by microarray. Inhibition zones were read every hour over 6–18 h of incubation. Concordance between earlier and 18-h readings was calculated for each hour. Results were validated on 224 isolates during routine clinical practice. For the initial 125 isolates, concordance (Cohen's κ) between the 6-h and 18-h readings was 0.88 [95% confidence interval (CI) 0.78–0.96; P 0.001]. The earliest time point for full concordance with the 18-h reading was 10 h. Validation of the 10-h reading for 224 clinical isolates resulted in a concordance of 0.99 (95% CI 0.98–1.0) between the 10-h and 18-h readings. Overall concordance on all 349 isolates was 0.99 (95% CI 0.97–1.0). Reading after 10 h of incubation has an excellent correlation with results after 18 h of incubation. This can significantly reduce the turnaround time for ESBL detection in laboratories with long opening hours or providing a 24/7 service. Consequently, there is a potential for implementing infection control measures up to 8 h earlier.
- Subjects :
- 0301 basic medicine
Microbiology (medical)
Pediatrics
medicine.medical_specialty
Time Factors
business.industry
Concordance
030106 microbiology
Esbl production
Confirmation test
General Medicine
beta-Lactamases
Confidence interval
Incubation period
03 medical and health sciences
Infectious Diseases
Enterobacteriaceae
Disk Diffusion Antimicrobial Tests
Internal medicine
medicine
Pharmacology (medical)
Routine clinical practice
business
Incubation
Subjects
Details
- ISSN :
- 09248579
- Volume :
- 50
- Database :
- OpenAIRE
- Journal :
- International Journal of Antimicrobial Agents
- Accession number :
- edsair.doi.dedup.....0b3a0bad47dd76595e8e7a279c09505c