The Poisoned Well: Enhancing the Predictive Value of Antimicrobial Susceptibility Testing in the Era of Multidrug Resistance

J Clin Microbiol. 2017 Aug;55(8):2304-2308. doi: 10.1128/JCM.00511-17. Epub 2017 May 3.

Abstract

Antimicrobial susceptibility testing (AST) is a fundamental mission of the clinical microbiology laboratory. Reference AST methods are based on bacterial growth in antibiotic doubling dilution series, which means that any error in the reference method inherently represents at least a 2-fold difference. We describe the origins of current AST reference methodology, highlight the sources of AST variability, and propose ideas for improving AST predictive power.

Keywords: antimicrobial activity; minimal inhibitory concentration; precision; susceptibility testing.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Drug Resistance, Multiple, Bacterial
  • Microbial Sensitivity Tests / standards*
  • Predictive Value of Tests*