Comparison of disc diffusion & E test methods with agar dilution for antimicrobial susceptibility testing of Haemophilus influenzae

Anand Manoharan, Rekha Pai, Shankar Viswanathan, Kurien Thomas, M. K. Lalitha

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background & objectives: Reliable methods of detection of antimicrobial resistance are of paramount importance in the treatment and management of infections caused by Haemophilus influenzae. The objective of the present study was to compare and evaluate the performance of disc diffusion and E test (Epsilometer test) with agar dilution method for antimicrobial susceptibility testing of H. influenzae. Methods: A total of 46 isolates of H. influenzae from various invasive sites were included as test strains. Antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method for ampicillin, chloramphenicol, trimethoprim-siilpbamethoxazole (TMP-SMZ) and cefotaxime. Minimum Inhibitory Concentration (MIC) determination was performed by E test and agar dilution for the same set of antimicrobials. All tests were performed on Haemophilus test medium (HTM). Results: Disc diffusion showed a very major (2%) and minor (4%) interpretative error with TMP-SMZ and minor interpretative errors to ampicillin (13%) and chloramphenicol (24%) when compared to agar dilution method. E test produced only minor interpretative errors to chloramphenicol (7%) and TMP-SMZ (2%) and no interpretative errors with ampicillin and cefotaxime as against agar dilution. E test showed good agreement with agar dilution for each of the antimicrobial tested. Interpretation & conclusion: Disc diffusion test may be used as a preliminary screen for susceptibility testing of H. influenzae. E test is simple, easy to perform and a reliable method for determination of resistance in H. influenzae. However its cost and limited availability in India may limit its use. The reference agar dilution method can be used reliably in routine susceptibility testing of H. influenzae.

Original languageEnglish (US)
Pages (from-to)81-87
Number of pages7
JournalIndian Journal of Medical Research
Volume117
Issue numberFEB.
StatePublished - Feb 1 2003
Externally publishedYes

Fingerprint

Haemophilus influenzae
Dilution
Agar
Trimethoprim
Testing
Chloramphenicol
Ampicillin
Disk Diffusion Antimicrobial Tests
Cefotaxime
Haemophilus
Microbial Sensitivity Tests
India
Availability
Costs and Cost Analysis
Infection
Costs

Keywords

  • Agar dilution
  • Disc diffusion
  • E test
  • Haemophilus influenzae
  • Haemophilus test medium
  • MIC

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Comparison of disc diffusion & E test methods with agar dilution for antimicrobial susceptibility testing of Haemophilus influenzae. / Manoharan, Anand; Pai, Rekha; Viswanathan, Shankar; Thomas, Kurien; Lalitha, M. K.

In: Indian Journal of Medical Research, Vol. 117, No. FEB., 01.02.2003, p. 81-87.

Research output: Contribution to journalArticle

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abstract = "Background & objectives: Reliable methods of detection of antimicrobial resistance are of paramount importance in the treatment and management of infections caused by Haemophilus influenzae. The objective of the present study was to compare and evaluate the performance of disc diffusion and E test (Epsilometer test) with agar dilution method for antimicrobial susceptibility testing of H. influenzae. Methods: A total of 46 isolates of H. influenzae from various invasive sites were included as test strains. Antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method for ampicillin, chloramphenicol, trimethoprim-siilpbamethoxazole (TMP-SMZ) and cefotaxime. Minimum Inhibitory Concentration (MIC) determination was performed by E test and agar dilution for the same set of antimicrobials. All tests were performed on Haemophilus test medium (HTM). Results: Disc diffusion showed a very major (2{\%}) and minor (4{\%}) interpretative error with TMP-SMZ and minor interpretative errors to ampicillin (13{\%}) and chloramphenicol (24{\%}) when compared to agar dilution method. E test produced only minor interpretative errors to chloramphenicol (7{\%}) and TMP-SMZ (2{\%}) and no interpretative errors with ampicillin and cefotaxime as against agar dilution. E test showed good agreement with agar dilution for each of the antimicrobial tested. Interpretation & conclusion: Disc diffusion test may be used as a preliminary screen for susceptibility testing of H. influenzae. E test is simple, easy to perform and a reliable method for determination of resistance in H. influenzae. However its cost and limited availability in India may limit its use. The reference agar dilution method can be used reliably in routine susceptibility testing of H. influenzae.",
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