This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Steward, C. D. Articles by Tenover, F. C. Search for Related Content PubMed PubMed Citation Articles by Steward, C. D. Articles by Tenover, F. C.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, January 2003, p. 351-358, Vol. 41, No. 1
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.1.351-358.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Antimicrobial Susceptibility Testing of Carbapenems: Multicenter Validity Testing and Accuracy Levels of Five Antimicrobial Test Methods for Detecting Resistance in Enterobacteriaceae and Pseudomonas aeruginosa Isolates

Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30333,¹ Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322²

Received 12 August 2002/ Returned for modification 24 September 2002/ Accepted 9 October 2002

From January 1996 to May 1999, Project ICARE (Intensive Care Antimicrobial Resistance Epidemiology) received 448 nonduplicate clinical isolates of Enterobacteriaceae and Pseudomonas aeruginosa that were reported to be imipenem intermediate or resistant. However, broth microdilution (BMD) confirmatory testing at the Project ICARE central laboratory confirmed this result in only 11 of 123 (8.9%) Enterobacteriaceae isolates and 241 of 325 (74.2%) P. aeruginosa isolates. To investigate this overdetection of imipenem resistance, we tested 204 selected isolates from the Project ICARE collection plus five imipenem-resistant challenge strains at the Centers for Disease Control and Prevention against imipenem and meropenem by agar dilution, disk diffusion, Etest (AB BIODISK North America, Inc., Piscataway, N.J.), two MicroScan WalkAway conventional panels (Neg MIC Plus 3 and Neg Urine Combo 3) (Dade MicroScan, Inc., West Sacramento, Calif.), and two Vitek cards (GNS-116 containing meropenem and GNS-F7 containing imipenem) (bioMérieux Vitek, Inc., Durham, N.C.). The results of each test method were compared to the results of BMD testing using in-house-prepared panels. Seven imipenem-resistant and five meropenem-resistant isolates of Enterobacteriaceae and 43 imipenem-resistant and 21 meropenem-resistant isolates of P. aeruginosa were identified by BMD. For Enterobacteriaceae, the imipenem and meropenem test methods produced low numbers of very major and major errors. All test systems in the study produced low numbers of very major and major errors when P. aeruginosa was tested against imipenem and meropenem, except for Vitek testing (major error rate for imipenem, 20%). Further testing conducted in 11 of the participating ICARE hospital laboratories failed to pinpoint the factors responsible for the initial overdetection of imipenem resistance. However, this study demonstrated that carbapenem testing difficulties do exist and that laboratories should consider using a second, independent antimicrobial susceptibility testing method to validate carbapenem-intermediate and -resistant results.

This article has been cited by other articles:

• Peleg, A. Y., Seifert, H., Paterson, D. L. (2008). Acinetobacter baumannii: Emergence of a Successful Pathogen. Clin. Microbiol. Rev. 21: 538-582 [Abstract] [Full Text]  
• Nayak, R., Call, V., Kaldhone, P., Tyler, C., Anderson, G., Phillips, S., Kerdahi, K., Foley, S. L. (2007). Comparison of Salmonella enterica serovar Heidelberg Susceptibility Testing Results. Clin Med Res 5: 98-105 [Abstract] [Full Text]  
• Menozzi, M. G., Eigner, U., Covan, S., Rossi, S., Somenzi, P., Dettori, G., Chezzi, C., Fahr, A.-M. (2006). Two-Center Collaborative Evaluation of Performance of the BD Phoenix Automated Microbiology System for Identification and Antimicrobial Susceptibility Testing of Gram-Negative Bacteria. J. Clin. Microbiol. 44: 4085-4094 [Abstract] [Full Text]  
• Giannoni, E., Moreillon, P., Cotting, J., Moessinger, A., Bille, J., Decosterd, L., Zanetti, G., Majcherczyk, P., Bugnon, D. (2006). Prospective determination of plasma imipenem concentrations in critically ill children.. Antimicrob. Agents Chemother. 50: 2563-2568 [Abstract] [Full Text]  
• Sader, H. S., Fritsche, T. R., Jones, R. N. (2006). Accuracy of Three Automated Systems (MicroScan WalkAway, VITEK, and VITEK 2) for Susceptibility Testing of Pseudomonas aeruginosa against Five Broad-Spectrum Beta-Lactam Agents.. J. Clin. Microbiol. 44: 1101-1104 [Abstract] [Full Text]  
• Giakkoupi, P., Tzouvelekis, L. S., Daikos, G. L., Miriagou, V., Petrikkos, G., Legakis, N. J., Vatopoulos, A. C. (2005). Discrepancies and Interpretation Problems in Susceptibility Testing of VIM-1-Producing Klebsiella pneumoniae Isolates. J. Clin. Microbiol. 43: 494-496 [Abstract] [Full Text]