Journal of Antimicrobial Chemotherapy, Vol 39, 87-92, Copyright © 1997 by The British Society for Antimicrobial Chemotherapy
AL Barry, PC Fuchs and SD Brown
For testing bacterial susceptibility to the streptogramin
quinupristin/dalfopristin, it seems reasonable that the test reagent should
contain a similar ratio of the two compounds as in the therapeutic
material, i.e. 30% quinupristin and 70% dalfopristin. The precise ratio of
quinupristin to dalfopristin is not critical as long as threshold
concentrations of both drugs are present. In-vitro tests were not altered
by minor changes in pH, incubation in CO2 or by addition of lysed horse
blood to the medium. Filter paper discs containing 15 micrograms of the
quinupristin/dalfopristin reagent are preferred for agar diffusion
susceptibility testing in order to optimize disc tests with enterococci.
Provisional interpretive criteria for pathogens not requiring blood or
increased CO2 are: susceptible, inhibition zone diameters of > or = 19
mm or MIC < or = 1.0 mg/L; intermediate, 16-18 mm or MIC 2.0 mg/L;
resistant, < or = 15 mm or MIC > or = 4.0 mg/L. Those criteria will
need to be reassessed as clinical experiences become available. Of
particular concern is the role of quinupristin/dalfopristin in the
treatment of infections due to Haemophilus influenzae or Enterococcus
faecalis: the clinically relevant interpretive category for each of those
two species is yet to be determined.
ORIGINAL ARTICLES
Provisional interpretive criteria for quinupristin/dalfopristin susceptibility tests
Clinical Microbiology Institute, Tualatin, OR 97062, USA.
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