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Journal of Clinical Microbiology, June 1999, p. 1881-1884, Vol. 37, No. 6
Department of Pathology,
Received 23 November 1998/Returned for modification 28 January
1999/Accepted 22 February 1999
Bactericidal testing historically has exhibited variable
reproducibility, even when prior standardized methods were employed. Several modifications to the National Committee for Clinical Laboratory Standards (NCCLS) broth macrodilution method are proposed to improve reproducibility. Recommended changes from the approved NCCLS guidelines (M21-A and M26-A) include omitting serum supplementation of
Mueller-Hinton broth, incubating tubes at 35°C for 24 h with no
agitation until they are sampled, running all tests in duplicate with
six dilutions instead of nine, reincubating the test for an additional
24 h to resolve discrepant bactericidal activity test results,
using a single 0.1-ml sample from each clear tube for subculture, and adopting an alternate method for calculating endpoint determination. In
order to test these recommendations in a clinical laboratory setting,
we used the modified methodology on 224 separate tests for bactericidal
activity. There were 102 serum bactericidal titer (SBT) and 122 minimum
bactericidal concentration (MBC) assays performed. By defining
reproducibility as agreement between duplicate tests ± 1 dilution, we found 207 of 224 tests (92%) were reproducible at the
24-h subculture point (94% for the SBT assay and 91% for the MBC
assay). When the 17 assays with discrepant results were incubated an
additional 24 h for a second subculture, only 1 of 224 tests
(0.4%) remained discrepant. The method used is practical for a
clinical laboratory that chooses to perform bactericidal activity
testing and assures a high level of reproducibility between duplicate
assays. The total cost of a test was approximately $25.00.
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Highly Reproducible Bactericidal Activity Test
Results by Using a Modified National Committee for Clinical Laboratory
Standards Broth Macrodilution Technique
*
Corresponding author. Mailing address: Clinical
Microbiology, Wesley Pavilion, Room 565, Northwestern Memorial
Hospital, 250 E. Superior St., Chicago, IL 60611. Phone: (312)
908-8192. Fax: (312) 908-4137. E-mail: lancer{at}nwu.edu.
Journal of Clinical Microbiology, June 1999, p. 1881-1884, Vol. 37, No. 6
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
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