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JAC Advance Access originally published online on October 29, 2003
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Journal of Antimicrobial Chemotherapy (2003) 52, 925-930
© 2003 The British Society for Antimicrobial Chemotherapy

Comparison of BSAC agar dilution and NCCLS broth microdilution MIC methods for in vitro susceptibility testing of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis: the BSAC Respiratory Resistance Surveillance Programme

Rosy Reynolds1,*, Jemma Shackcloth2, David Felmingham2 and Alasdair MacGowan1 on behalf of the BSAC Extended Working Party on Respiratory Resistance Surveillance

1 Department of Medical Microbiology, North Bristol NHS Trust, Southmead Hospital, Bristol BS10 5NB; 2 GR Micro Ltd, 7–9 William Road, London NW1 3ER, UK

Received 1 July 2003; returned 9 August 2003; revised 26 August 2003; accepted 28 August 2003

Objective: The aim of this study was to establish the degree of comparability between the NCCLS broth microdilution and BSAC agar dilution MIC methods of antimicrobial susceptibility testing.

Methods: Six hundred and sixty-one clinical isolates of Streptococcus pneumoniae, 936 Haemophilus influenzae and 421 Moraxella catarrhalis, collected in the winter of 1999–2000 by 20 laboratories in the UK and Eire from patients with presumed community-acquired lower respiratory infections, were tested by the two methods. MIC agreement was defined as excellent (good) if results were within ±1 doubling dilution for >=90% (>=80%) of isolates and within ±2 doubling dilutions for >=95%. Isolates were categorized as susceptible, intermediate or resistant using the breakpoints appropriate to the testing method.

Results: MIC agreement was good or excellent in 27 of 36 organism–agent combinations. Agreement was less for M. catarrhalis than for other species, and lower in all three species for cefaclor and trimethoprim than for other antimicrobials. Discrepancies in categorization occurred only occasionally, and were generally explained by differences in breakpoints rather than in measured MICs. One exception was S. pneumoniae with penicillin. Despite excellent MIC agreement and identical breakpoints, 9% of these had minor discrepancies, mainly because 7% of isolates were found intermediate by the BSAC method but resistant by the NCCLS method.

Conclusion: There is generally very good agreement between the MICs obtained by the BSAC agar dilution and NCCLS broth microdilution methods in this population of isolates, comparable to the level of agreement achieved between different laboratories using a single method. Breakpoint differences contribute to most of the discrepancies in susceptibility categorization.

Keywords: methodology, antimicrobial susceptibility, respiratory pathogens

* Corresponding author. Tel: +44-117-959-4080; Fax: +44-117-959-3154; E-mail: rosy.reynolds{at}btinternet.com


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