The DOI matches its Crossref record, with a small difference in title or year; 22 of the 22 references it cites were found in a registry or an index.
Comparative Evaluation of the VITEK 2, Disk Diffusion, Etest, Broth Microdilution, and Agar Dilution Susceptibility Testing Methods for Colistin in Clinical Isolates, Including Heteroresistant Enterobacter cloacae and Acinetobacter baumannii Strains
Open accessAbstract
Increasing antibiotic resistance in gram-negative bacteria has recently renewed interest in colistin as a therapeutic option. The increasing use of colistin necessitates the availability of rapid and reliable methods for colistin susceptibility testing. We compared seven methods of colistin susceptibility testing (disk diffusion, agar dilution on Mueller-Hinton [MH] and Isosensitest agar, Etest on MH and Isosensitest agar, broth microdilution, and VITEK 2) on 102 clinical isolates collected from patient materials during a selective digestive decontamination or selective oral decontamination trial in an intensive-care unit. Disk diffusion is an unreliable method to measure susceptibility to colistin. High error rates and low levels of reproducibility were observed in the disk diffusion test. The colistin Etest, agar dilution, and the VITEK 2 showed a high level of agreement with the broth microdilution reference method. Heteroresistance for colistin was observed in six Enterobacter cloacae isolates and in one Acinetobacter baumannii isolate. This is the first report of heteroresistance to colistin in E. cloacae isolates. Resistance to colistin in these isolates seemed to be induced upon exposure to colistin rather than being caused by stable mutations. Heteroresistant isolates could be detected in the broth microdilution, agar dilution, Etest, or disk diffusion test. The VITEK 2 displayed low sensitivity in the detection of heteroresistant subpopulations of E. cloacae . The VITEK 2 colistin susceptibility test can therefore be considered to be a reliable tool to determine susceptibility to colistin in isolates of genera that are known not to exhibit resistant subpopulations. In isolates of genera known to (occasionally) exhibit heteroresistance, an alternative susceptibility testing method capable of detecting heteroresistance should be used.
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“studies have shown a significant correlation between E-test results and MIC values obtained through broth or agar dilution methods [69, 70].”
From Methods for screening and evaluation of antimicrobial activity: A review of protocols, advantages, and limitations (2024) · cites this paper as [69]
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Metadata
- Authors
- Lo-Ten-Foe, J. R., de Smet, A. M. G. A., Diederen, B. M. W., Kluytmans, J. A. J. W., & van Keulen, P. H. J.
- Affiliations
- Laboratory for Microbiology and Infection Control, Amphia Hospital, Breda, The Netherlands
- University Medical Center Utrecht (NL)
- Amphia Ziekenhuis (NL)
- Venue
- Antimicrobial Agents and Chemotherapy
- Publisher
- American Society for Microbiology
- Published
- 2007-10
- Volume
- 51
- Issue
- 10
- Pages
- 3726-3730
- ISSN
- 0066-4804 (ISSN-L)
- 1098-6596
- PMC
- PMC2043258
- OpenAlex
- W2142419984
- Cited by
- 242
- References
- 22
- Citations by year
- 2026: 15 · 2025: 10 · 2024: 16 · 2023: 19 · 2022: 14 · 2021: 9 · 2020: 22 · 2019: 16 · 2018: 19 · 2017: 24 · 2016: 13 · 2015: 11 · 2014: 9 · 2013: 11 · 2012: 7
- FWCI
- 3.30
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Antimicrobial Agents and Chemotherapy (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Microbiology (medical) › Antibiotic Resistance in Bacteria
- Health Sciences › Medicine › Microbiology (medical) › Bacterial Identification and Susceptibility Testing
- Health Sciences › Medicine › Pharmacology (medical) › Antibiotics Pharmacokinetics and Efficacy
- Keywords
- colistin, colistin susceptibility testing, heteroresistance, Enterobacter cloacae, Acinetobacter baumannii, disk diffusion, E-test, broth microdilution, agar dilution, VITEK 2, selective decontamination of the digestive tract, intensive care unit, Gram-negative bacteria, antibiotic resistance
- MeSH terms
- Acinetobacter Infections, Agar, Anti-Bacterial Agents, Bacterial Infections, Colistin, Cross Infection, Culture Media, Enterobacteriaceae Infections, Humans, Intensive Care Units, Microbial Sensitivity Tests, Polymyxin B, Enterobacter cloacae, Drug Resistance, Multiple, Bacterial, Acinetobacter baumannii
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