Multicenter study of automated systems for colistin susceptibility testing
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ORIGINAL ARTICLE
Multicenter study of automated systems for colistin susceptibility testing Ahalieyah Anantharajah 1 & Youri Glupczynski 1 & Martin Hoebeke 1 & Pierre Bogaerts 1 & Philippe Declercq 2 & Olivier Denis 1,3,4 & Julie Descy 5 & Katelijne Floré 6 & Koen Magerman 7 & Hector Rodriguez-Villalobos 8 & Anne-Marie Van den Abeele 9 & Te-Din Huang 1 Received: 12 August 2020 / Accepted: 30 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Broth microdilution (BMD) stays as the reference testing method for determination of antimicrobial susceptibility testing (AST) to colistin and is considered essential for patient management and for monitoring of colistin resistance. This multicenter study aimed to evaluate the performance of automated systems for colistin AST among Enterobacterales as an alternative for BMD since the majority of laboratories use automated systems as first-line method. Methods Twenty colistin resistant (COL-R) including 10 MCR producers and 10 colistin-susceptible (COL-S) Enterobacterales isolates were blindly tested for colistin susceptibility with the routine automated AST systems used by 8 laboratories (3 with BD Phoenix, 3 with Vitek2 and 2 with MicroScan). Additionally, 3 reference strains (E. coli ATCC 25922, E. coli NCTC 13846, and one COL-R mcr-negative K. pneumoniae M/14750) were tested in triplicate by each laboratory. Results and conclusion Results were compared with BMD performed at the reference laboratory. BD Phoenix and MicroScan automated AST systems provide accurate and reproducible categorical results for the testing of colistin in Enterobacterales. However, Vitek2 system showed poor performance for the detection of COL-R isolates especially those with MICs close to the susceptibility breakpoint (categorical agreement of 88% and precision categorical agreement of 81%). Keywords Colistin . Enterobacterales . Antimicrobial susceptibility testing . Automated systems . MicroScan . BD Phoenix . Vitek2
Introduction The multidrug antimicrobial resistance of Gram-negative has become a major public health issue impacting negatively on the clinical outcome of infected patients. Colistin is an old antibiotic that regained popularity as a last resort drug to treat infections caused by these multidrug-resistant organisms * Ahalieyah Anantharajah [email protected] 1
2
Department of Clinical Microbiology, National reference center for antibiotic-resistant Gram-negative bacilli, CHU UCL Namur, Yvoir, Belgium Department of Laboratory Medicine, Sint Jozefskliniek, Izegem, Belgium
3
Ecole de Santé Publique, ULB, Brussels, Belgium
4
Department of Laboratory Medicine, CHIREC Delta, Brussels, Belgium
(MDROs). The emerging resistance to colistin (COL-R), whether arising by chromosomal mutations or by plasmidmediated (MCR) mechanisms (which in all cases lead to modifications of the lipopolysaccharides of the outer membrane in gram-negative bacteria), is now recognized in animals, food animal products, and human samples, and it repr
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