Sunday, July 17, 2011

Antimicrobial Susceptibility Testing

Susceptibility testing involves testing pathogens against antimicrobial agents to determine if the bacteria express resistance to agents that could potentially be used in treatment. The microdilution method of measuring antimicrobial susceptibility is commonly employed in the clinical laboratory. The procedure begins by preparing a standard suspension of the organism and dispensing it into the seed tray. A specialized inoculator device with prongs dispenses 0.01 mL of inoculum into wells of microdilution trays containing various concentrations of antimicrobial agents. The plates are continuously monitored by an automated system.The instrument detects the growth in the wells by spectrophotometry (or fluorometric analysis) by comparing wells with antimicrobics to control wells without antimicrobics. 


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The antimicrobial agents that are chosen for testing against a particular bacterial isolate are referred to as the antimicrobial battery. Antimicrobials to which the organism is intrinsically resistant are routinely excluded from the test battery. Similarly, certain antimicrobials were specifically developed for use against particular organisms but not others and should be included in the appropriate battery. If resistance to a particular agent is common, the utility of the agent may be sufficiently limited so that routine testing is not warranted and only more potent antimicrobials are included in the test battery. Conversely, more potent agents may not need to be in the test battery is susceptibility to less potent agents is highly prevalent. 

Further considerations about antibiotics may be employed against particular organism groups. The most common individual testing batteries are considered for Enterobacteriaceae, P. aeruginosa, Acenitobacter spp, Staphylococcus spp, Enterococcus spp, Streptococcus spp, Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria gonorrhoeae. Below is a link to an example of specific information for susceptibility testing of S. pneumoniae.

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