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Klebsiella pneumoniae and Colistin Susceptibility Testing: Performance Evaluation for Broth Microdilution, Agar Dilution and Minimum Inhibitory Concentration Test Strips and Impact of the Skipped Well Phenomenon

2021-12-14Journal article Open access
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dc.contributor.authorElias, Rita
dc.contributor.authorMelo Cristino, José
dc.contributor.authorLito, Luís
dc.contributor.authorPinto, Margarida
dc.contributor.authorGonçalves, Luísa
dc.contributor.authorCampino, Susana
dc.contributor.authorClark, Taane
dc.contributor.authorDuarte, Aida
dc.contributor.authorPerdigão, João
dc.date.accessioned2023-09-08T16:58:05Z
dc.date.available2023-09-08T16:58:05Z
dc.date.issued2021-12-14
dc.date.updated2023-03-13T20:19:35Z
dc.description.abstractThe emergence of multidrug resistant Gram-negative pathogens, particularly carbapenemase producers, has forced clinicians to use last line antibiotics, such as colistin. Since colistin susceptibility testing presents several challenges, this study aimed at evaluating the performance of two alternative susceptibility methods for Klebsiella pneumoniae, namely, agar dilution (AD) and MIC test strips (MTS). These approaches were compared with the reference method, broth microdilution (BMD), and provide a quantitative description for the “skipped well” (SW) phenomenon. Colistin susceptibility was evaluated by BMD and AD in parallel and triplicate, using 141 K. pneumoniae clinical isolates while MTS performance was evaluated only for a subset (n = 121). Minimum inhibitory concentration analysis revealed that a substantial part (n = 26/141; 18.4%) of the initial isolates was deemed undetermined by BMD due to the following: discordance between replicates (1.4%); presence of multiple SWs (7.8%); and the combination of both events (9.2%). Both AD and MTS revealed a high number of false-susceptible strains (“very major errors”), 37.5% and 68.8%, respectively. However, AD agreement indices were reasonably high (EA = 71.3% and CA = 94.8%). For MTS these indices were lower, in particular EA (EA = 41.7% and CA = 89.6), but the approach enabled the detection of distinct sub-populations for four isolates. In conclusion, this study provides the most comprehensive study on the performance of AD and MTS for colistin susceptibility testing in K. pneumoniae, highlighting its limitations, and stressing the importance of sample size and composition. Further, this study highlights the impact of the SW phenomenon associated with the BMD method for K. pneumoniae.pt_PT
dc.description.sponsorshipThis research was partially funded by UID/DTP/04138/2019 from Fundação para a Ciência e Tecnologia (FCT), Portugal and by Associação para o Desenvolvimento do Ensino e Investigação da Microbiologia (ADEIM). JP [CEECIND/00394/2017] is supported by Fundação para a Ciência e Tecnologia through Estímulo Individual ao Emprego Científico. TGC received funding from the MRC UK (Grant no. MR/K000551/1, MR/M01360X/1, MR/N010469/1, MR/R020973/1, MR/R025576/1, MR/S01988X/1, MR/S03563X/1) and BBSRC UK (BB/R013063/1). SC received funding from the Medical Research Council UK grants (MR/R020973/1, MR/R025576/1, MR/S01988X/1, MR/S03563X/1) and the BBSRC UK (BB/R013063/1).pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationElias R, Melo-Cristino J, Lito L, Pinto M, Gonçalves L, Campino S, et al. Klebsiella pneumoniae and Colistin Susceptibility Testing: Performance Evaluation for Broth Microdilution, Agar Dilution and Minimum Inhibitory Concentration Test Strips and Impact of the “Skipped Well” Phenomenon. Diagnostics [Internet]. 2021 Dec 14;11(12):2352. Available from: http://dx.doi.org/10.3390/diagnostics11122352pt_PT
dc.identifier.doi10.3390/diagnostics11122352pt_PT
dc.identifier.issn2075-4418
dc.identifier.slugcv-prod-2853909
dc.identifier.urihttp://hdl.handle.net/10451/59190
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherMDPIpt_PT
dc.relationResearch Institute for Medicines
dc.relationNot Available
dc.relation.publisherversionhttps://www.mdpi.com/2075-4418/11/12/2352pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectKlebsiella pneumoniaept_PT
dc.subjectcolistinpt_PT
dc.subjectsusceptibility testingpt_PT
dc.subjectskipped wellspt_PT
dc.titleKlebsiella pneumoniae and Colistin Susceptibility Testing: Performance Evaluation for Broth Microdilution, Agar Dilution and Minimum Inhibitory Concentration Test Strips and Impact of the Skipped Well Phenomenonpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleResearch Institute for Medicines
oaire.awardTitleNot Available
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UID%2FDTP%2F04138%2F2019/PT
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/CEEC IND 2017/CEECIND%2F00394%2F2017%2FCP1476%2FCT0001/PT
oaire.citation.issue12pt_PT
oaire.citation.startPage2352pt_PT
oaire.citation.titleDiagnosticspt_PT
oaire.citation.volume11pt_PT
oaire.fundingStream6817 - DCRRNI ID
oaire.fundingStreamCEEC IND 2017
person.familyNameElias
person.familyNameMelo Cristino
person.familyNameCampino Clark
person.familyNameClark
person.familyNameDuarte
person.familyNameLucas Mota Perdigão
person.givenNameRita
person.givenNameJosé
person.givenNameSusana
person.givenNameTaane
person.givenNameAida
person.givenNameJoão Ruben
person.identifier642245
person.identifier2524696
person.identifier.ciencia-id4F17-84D2-B49E
person.identifier.ciencia-id871E-6AD6-F37C
person.identifier.ciencia-idEF14-DC2D-A029
person.identifier.ciencia-idDD1B-2564-161C
person.identifier.ciencia-idD517-F4DB-17C1
person.identifier.ciencia-id991C-F26A-9843
person.identifier.orcid0000-0001-6959-9005
person.identifier.orcid0000-0001-8643-1722
person.identifier.orcid0000-0003-1403-6138
person.identifier.orcid0000-0001-8985-9265
person.identifier.orcid0000-0002-0616-4650
person.identifier.orcid0000-0002-0339-1305
person.identifier.ridH-3726-2013
person.identifier.ridM-5272-2013
person.identifier.scopus-author-id57220858605
person.identifier.scopus-author-id7004053640
person.identifier.scopus-author-id7403216793
person.identifier.scopus-author-id35495748300
person.identifier.scopus-author-id24723211800
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.cv.cienciaid991C-F26A-9843 | João Ruben Lucas Mota Perdigão
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
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