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Which antibiotics and breakpoints should be used for Aeromonas susceptibility testing? Considerations from a comparison of agar dilution and disk diffusion methods using Enterobacteriaceae breakpoints

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Abstract

Aeromonas species are environmental organisms that are responsible for numerous infections in humans and animals. Their antimicrobial susceptibility is usually evaluated using Enterobacteriaceae breakpoints. Although disk diffusion and minimum inhibitory concentration (MIC)-based methods are important for infectious disease management and epidemiological surveys of resistance, comparisons between these two methods have not been extensively studied for Aeromonas isolates. We propose the first extensive comparison of agar dilution and disk diffusion susceptibility testing methods, performed for 20 antimicrobial agents, including unevaluated or incompletely evaluated antibiotics (ticarcillin with or without clavulanic acid, ertapenem, tigecycline), on 146 Aeromonas isolates affiliated with six Aeromonas species via molecular means. We evaluated the level of agreement between Enterobacteriaceae breakpoints-based methods. Reliable agreement (>95%) was observed for piperacillin, cefotaxime, cefepime, nalidixic acid, ofloxacin, ciprofloxacin, gentamicin, amikacin, tetracycline and cotrimoxazole, whereas marked inconsistencies between the methods were noted for carbapenems, amoxicillin–clavulanic acid, ticarcillin, ticarcillin–clavulanic acid, tobramycin and tigecycline. The results indicate that beta-lactam and aminoglycoside susceptibility testing should be limited to piperacillin, cephems, gentamicin and amikacin. Co-amoxiclav should be avoided given the lack of agreement between the two methods. Adjusting the zone diameter breakpoints for tigecycline and cefoxitin could also improve the agreement to >95% and reduce the error rates to acceptable levels.

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Acknowledgements

Members of the colBVH Study Group who participated in this study are: F. Carmagnol (Cannes), E. Chachaty (Institut Gustave Roussy), C. Alba-Sauviat (Chaumont), C. Auvray (Charleville-Mézières), D. Barraud (Gonesse), Z. Benseddik (Chartres), A. Bertrou (Carcassonne), F. Bessis (Cherbourg), H. Biessy (La Rochelle), V. Blanc (Antibes-Juan-les-Pins), Y. Boucaud-Maitre (Lyon), Brunet & Michel (Marseille), B. Cancet (Villeneuve/Lot), J. Carrere (Hyères), A. Cecille (Digne-les-Bains), G. Chambreuil (La Roche/Yon), P. Chantelat (Vesoul), H. Chardon (Aix en Provence), Charrel (Salon de Provence), H. De Montclos (Bourg-en-Bresse), J.W. Decousser (Dourdan; Rambouillet), J.M. Delarbre/A.Gravey (Mulhouse), D. Deligne (Remiremont), C. Denoix (La Réunion), J. Deregnaucourt (Paris (H L. Bellon)), F. Desroys du Roure (Chatellerault), Dubourdieu (Gisors), Z. El Harrif (Libourne), C. Eloy (Troyes), A. Evers (Annonay), C. Febvre (Montbéliard), D. Fevre (Vienne), S. Gabriel (Monaco), M.J. Galanti (Coulommiers), E. Garnotel (Marseille (HIA Laveran)), M. Gavignet (Lavaur), F. Geffroy (Quimper), G. Grise (Elbeuf-Louviers), I. Gros (Saint-Denis), I. Hermes (Saint-Malo), J. Heurte (Beauvais), Heusse (Bayeux), D. Jan (Laval), E. Jaouen (Sablé/Sarthe), S. Laluque (Montluçon), R. Lamarca (Narbonne), B. Lamy (Sète), Laurens (Belfort), A. Le Coustumier (Cahors), E. Lecaillon (Perpignan), C. Lemble (Selestat), M. Leneveu (Poissy; Saint Germain), S. Leotard (Grasse), M.N. Letouzey (Villefranchesur-Saone), Malbrunot (Corbeil-Essonnes), O. Menouni (Montceau-les-Mines), Morel (Le Havre), C. Olive (Fort de France), B. Pangon (Versailles), J.G. Paul (Boulogne-sur-Mer), J.M. Perez (Pte à Pitre), P. Pouedras (Vannes), D. Pressac (Tulle), R. Sanchez (Périgueux), Y. Scat (Pontivy), A. Secher (Dreux), J. Semon (Chalon-sur-Saône), D. Simeon (Langres), C. Simonin (Macon), J.P. Thellier (Château Thierry), B. Tourand (Alès), A. Vachée (Roubaix), Varache (Le Mans), J. Vaucel (St. Brieux), A.C. Vautrin (Saint-Étienne), Verhaeghe (Dunkerke), M. Villemain (Aurillac), L. Villeneuve (Aubagne).

This manuscript has been checked for English language accuracy by American Journal Experts.

Funding

This work was supported by the Association des Biologistes de l’Ouest and by the Laboratoire de Diagnostic Bactériologique de l’Ecole Nationale Vétérinaire de Lyon and is partly supported by the association ADEREMPHA (Association pour la Recherche et le Développement en Microbiologique & Pharmacie).

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Montpellier, Hôpital Arnaud de Villeneuve, 191, Avenue du Doyen Gaston Giraud, 34295, Montpellier, France

    B. Lamy & H. Marchandin

  2. colBVH, Collège de Bactériologie, Virologie et Hygiène des Hôpitaux Généraux, Le Chesnay, France

    B. Lamy & F. Laurent

  3. Groupe d’Etude Français des Aeromonas (GFA), Lyon, France

    B. Lamy, F. Laurent & A. Kodjo

  4. Equipe Pathogènes et Environnements, Université Montpellier 1, UMR 5119 ECOSYM, Montpellier, France

    B. Lamy, F. Roger, E. Jumas-Bilak & H. Marchandin

  5. Laboratoire de Bactériologie de l’Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France

    F. Laurent

  6. INSERM U851, Université de Lyon, Lyon, France

    F. Laurent

  7. Université de Lyon, CNRS UMR 5557 Ecologie Microbienne, Université Lyon 1, VetAgro Sup Campus Vétérinaire de Lyon, Lyon, France

    A. Kodjo

  8. Laboratoire d’Hygiène Hospitalière, Centre Hospitalier Universitaire de Montpellier, Montpellier, France

    E. Jumas-Bilak

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Correspondence to B. Lamy.

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Lamy, B., Laurent, F., Kodjo, A. et al. Which antibiotics and breakpoints should be used for Aeromonas susceptibility testing? Considerations from a comparison of agar dilution and disk diffusion methods using Enterobacteriaceae breakpoints. Eur J Clin Microbiol Infect Dis 31, 2369–2377 (2012). https://doi.org/10.1007/s10096-012-1578-x

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