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Journal of Clinical Microbiology, January 2001, p. 43-46, Vol. 39, No. 1
The Clinical Microbiology Institute,
Wilsonville, Oregon 97070
Received 14 August 2000/Returned for modification 30 September
2000/Accepted 19 October 2000
The National Committee for Clinical Laboratory Standards standard
broth microdilution method for testing the susceptibility of
Haemophilus influenzae to ampicillin, azithromycin,
clarithromycin, and telithromycin was evaluated by altering one
variable at a time. Variables that were tested included age of colony
for inoculum preparation, inoculum density, test medium, incubation
atmosphere, and incubation time. For the macrolide, azalide, and
ketolide agents, incubation in 5 to 7% CO2 most
significantly affected the MICs, producing nearly twofold increases for
clarithromycin and telithromycin and a greater than threefold increase
for azithromycin. For ampicillin, a 10-fold increase in inoculum
density increased the geometric mean MICs for
0095-1137/01/$04.00+0 DOI: 10.1128/JCM.39.1.43-46.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Influence of Variations in Test Methods on
Susceptibility of Haemophilus influenzae to Ampicillin,
Azithromycin, Clarithromycin, and Telithromycin
-lactamase-negative
strains from 1.50 to 2.45 µg/ml. In addition, 206 H. influenzae strains were tested for their susceptibilities to the
same drugs by the broth microdilution tests in two media, as well as by
agar dilution tests, disk diffusion tests, and Etests, on six different
agar media. The three standard methods with Haemophilus
test medium (HTM) compared favorably with each other except for a high
minor discrepancy rate (27%) by the disk diffusion test with
ampicillin and clarithromycin. Agar dilution test MICs on the five
comparative media were generally higher than those on HTM agar but were
only rarely more than one twofold concentration higher. Etest MICs of
azithromycin and telithromycin were more than twofold higher than agar
dilution and broth microdilution MICs on HTM; ampicillin Etest MICs
were nearly twofold lower. The use of media other than HTM agar appears
to have a minimal effect on susceptibility test results for the
ketolide, azalide, or macrolide drugs that we tested against H. influenzae.
*
Corresponding author. Mailing address: 9725 SW Commerce
Circle, Suite A-1, Wilsonville, OR 97070. Phone: (503) 682-3232. Fax: (503) 682-4548. E-mail: CMI{at}hevanet.com.
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