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Journal of Clinical Microbiology, January 1999, p. 215-217, Vol. 37, No. 1
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Determination of Trimethoprim-Sulfamethoxazole Resistance in Streptococcus pneumoniae by Using the E Test with Mueller-Hinton Agar Supplemented with Sheep or Horse Blood May Be Unreliable

M. Lovgren,1,* L. Dell'Acqua,2 R. Palacio,2 G. Echániz-Aviles,3 A. Soto-Noguerón,3 E. Castañeda,4 C. I. Agudelo,4 I. Heitmann,5 M. C. Brandileone,6 R. C. Zanella,6 A. Rossi,7 J. Pace,7 J. A. Talbot,1 and The Pneumococcal Study Groupdagger

National Centre for Streptococcus, Edmonton, Canada1; Departamento de Laboratorios de Salud, Ministerio de Salud Pública, Montevideo, Uruguay2; Instituto Nacional de Salud Pública, Cuernavaca, Mexico3; Instituto Nacional de Salud, Bogotá, Colombia4; Instituto de Salud Pública, Santiago, Chile5; Instituto Adolfo Lutz, São Paulo, Brazil6; and Instituto Nacional de Microbiología Dr. Carlos Malbran, Buenos Aires, Argentina7

Received 7 July 1998/Returned for modification 29 July 1998/Accepted 29 September 1998

An international, multicenter study compared trimethoprim-sulfamethoxazole MICs for 743 Streptococcus pneumoniae isolates (107 to 244 isolates per country) by E test, using Mueller-Hinton agar supplemented with 5% defibrinated horse blood or 5% defibrinated sheep blood, with MICs determined by the National Committee for Clinical Laboratory Standards broth microdilution reference method. Agreement within 1 log2 dilution and minor error rates were 69.3 and 15.5%, respectively, on sheep blood-supplemented agar and 76.9 and 13.6%, respectively, with horse blood as the supplement. Significant interlaboratory variability was observed. E test may not be a reliable method for determining the resistance of pneumococci to trimethoprim-sulfamethoxazole.

* Corresponding author. Mailing address: National Centre for Streptococcus, Rm. 1B3.26 WMC, University of Alberta Hospital, 8440-112 St., Edmonton, Alberta, Canada T6G 2J2. Phone: (403) 492-8977. Fax: (403) 492-8984. E-mail: ml{at}bugs.uah.ualberta.ca.

dagger Members of The Pneumococcal Study Group are J. Weekes, L. McKercher, B. Forwick, and T. Ng, from National Centre for Streptococcus, Edmonton, Canada; M. Hortal, from Departmento de Laboratorios de Salud, Ministerio de Salud Pública, Montevideo, Uruguay; M. N. Carnalla, M. E. Velazquez, Y. Jimenez, P. Cárdenas, A. Peréz, F. J. López-Antunano, and F. Solórzano, from Instituto Nacional de Salud Pública, Cuernavaca, Mexico; S. T. Casagrande and S. C. G. Almeida, from Instituto Adolfo Lutz, São Paulo, Brazil; and A. Corso, from Instituto Nacional de Microbiología Dr. Carlos Malbran, Buenos Aires, Argentina.

Journal of Clinical Microbiology, January 1999, p. 215-217, Vol. 37, No. 1
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.




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