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Failure to detect resistance in antimicrobial susceptibility tests
A N N L D O 1(4) 27-34, 1984
ISSN 0738-1751
V O L U M E 1, N U M B E R 4, A P R I L 1984
EDITORIAL B O A R D
Editor
Associate Editors
DANIEL AMSTERDAM, PhD
RONALD N. JONES, MD
CLYDE THORNSBERRY,PhD
State University of New York at Buffalo and Erie County Laboratory
Kaiser-Permanente Medical Care Program
Center for Infectious Diseases, Centers for Disease Control
HAROLD C. NEU, MD
LOWELL S. YOUNG, MD
College of Physicians and Surgeons,
UCLASchool of Medicine
Columbia University
CONTENTS Editor's Note
27
D. AMSTERDAM
Failure to Detect Resistance in Antimicrobial Susceptibility Tests: A "Very Major" Error of Increasing Concern 27 CHRISTINE C. SANDERS EDITORIAL COMMENT
FAILURE TO DETECT RESISTANCE IN ANTIMICROBIAL SUSCEPTIBILITY TESTS A "Very Major" Error of Increasing Concern C H R I S T I N E C. S A N D E R S Associate Professor, Department of Medical Microbiology, Creighton University School of Medicine, Omaha, NE 68178
32
The antimicrobial susceptibility test is one of the most important procedures performed in the clinical microbiology laboratory. Until recently, the disk diffusion assay of Bauer et al 1 has been the basic susceptibility test performed in hospital laboratories. Although far from ideal, the disk diffusion test is advantageous because it is relatively simple and inexpensive to perform,
Editor's Note
On occasion, the nature of an invited article will prompt Editorial comment. The issues raised by Dr. Sander's contribution to this month's A M N are of concern to all those who generate and utilize antimicrobic susceptibility data. For this reason we have ex-
ELSEVIER
tended the discussion of antimicrobic susceptibility methods and the clinical relevance of/3-1actamase induction stimulated by fl-lactam compounds. In the next issue of The A M N , Associate Editor Ron Jones initiates the section " N e w Drugs" that will appear periodically. The subject will be the
it is well-controlled, and there has been considerable worldwide experience with it. Additionally, it is the one test used extensively in premarketing studies with new antimicrobial agents. Thus interpretive criteria for the disk diffusion test are usually established by the time new antibiotics become available for clinical use. Two major disadvantages of the disk diffusion test--ie, the qualitative data it generates and its requirement for overnight incub a t i o n - h a v e stimulated interest in developing new susceptibility test procedures.
quinolones. The format will consist of some concise background to the general class of compounds, a codified list with appropriate contact(s) at pharmaceutical companies, and citations of early (usually in vitro) studies. An in-depth review of the quinolones will appear in a forthcoming issue of The A M N .
073s-1751/8 0.00+2.00
ISSN 0738-1751
V O L U M E 1, N U M B E R 4, A P R I L 1984
EDITORIAL B O A R D
Editor
Associate Editors
DANIEL AMSTERDAM, PhD
RONALD N. JONES, MD
CLYDE THORNSBERRY,PhD
State University of New York at Buffalo and Erie County Laboratory
Kaiser-Permanente Medical Care Program
Center for Infectious Diseases, Centers for Disease Control
HAROLD C. NEU, MD
LOWELL S. YOUNG, MD
College of Physicians and Surgeons,
UCLASchool of Medicine
Columbia University
CONTENTS Editor's Note
27
D. AMSTERDAM
Failure to Detect Resistance in Antimicrobial Susceptibility Tests: A "Very Major" Error of Increasing Concern 27 CHRISTINE C. SANDERS EDITORIAL COMMENT
FAILURE TO DETECT RESISTANCE IN ANTIMICROBIAL SUSCEPTIBILITY TESTS A "Very Major" Error of Increasing Concern C H R I S T I N E C. S A N D E R S Associate Professor, Department of Medical Microbiology, Creighton University School of Medicine, Omaha, NE 68178
32
The antimicrobial susceptibility test is one of the most important procedures performed in the clinical microbiology laboratory. Until recently, the disk diffusion assay of Bauer et al 1 has been the basic susceptibility test performed in hospital laboratories. Although far from ideal, the disk diffusion test is advantageous because it is relatively simple and inexpensive to perform,
Editor's Note
On occasion, the nature of an invited article will prompt Editorial comment. The issues raised by Dr. Sander's contribution to this month's A M N are of concern to all those who generate and utilize antimicrobic susceptibility data. For this reason we have ex-
ELSEVIER
tended the discussion of antimicrobic susceptibility methods and the clinical relevance of/3-1actamase induction stimulated by fl-lactam compounds. In the next issue of The A M N , Associate Editor Ron Jones initiates the section " N e w Drugs" that will appear periodically. The subject will be the
it is well-controlled, and there has been considerable worldwide experience with it. Additionally, it is the one test used extensively in premarketing studies with new antimicrobial agents. Thus interpretive criteria for the disk diffusion test are usually established by the time new antibiotics become available for clinical use. Two major disadvantages of the disk diffusion test--ie, the qualitative data it generates and its requirement for overnight incub a t i o n - h a v e stimulated interest in developing new susceptibility test procedures.
quinolones. The format will consist of some concise background to the general class of compounds, a codified list with appropriate contact(s) at pharmaceutical companies, and citations of early (usually in vitro) studies. An in-depth review of the quinolones will appear in a forthcoming issue of The A M N .
073s-1751/8 0.00+2.00