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European Journal of Clinical Microbiology & Infectious Diseases

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19-01-2024 | Pseudomonas Aeruginosa | Original Article

Performance evaluation of Bruker UMIC^® microdilution panel and disc diffusion to determine cefiderocol susceptibility in Enterobacterales, Acinetobacter baumannii, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Achromobacter xylosoxidans and Burkolderia species

Authors: Gabriele Bianco, Matteo Boattini, Sara Comini, Paolo Gaibani, Rossana Cavallo, Cristina Costa

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 3/2024

Abstract

Purpose

Cefiderocol susceptibility testing (AST) represents an open challenge for clinical microbiology. Herein, we evaluated the performance of the UMIC^® Cefiderocol broth microdilution (BMD) test and disc diffusion on Gram-negative species.

Methods

UMIC^® Cefiderocol BMD test, disc diffusion and reference BMD were in parallel performed on a collection of 256 clinical isolates. Categorical agreement (CA), essential agreement (EA), bias, major errors (MEs) and very major errors (VMEs) were calculated for both AST methods.

Results

The UMIC^® Cefiderocol BMD strip exhibited an EA < 90% (85.5%), a CA higher than 90% (93.7%) and a low number of VMEs (n = 4, 4.2%) and MEs (n = 12, 7.4%). UMIC^® Cefiderocol identified 96.2% of the resistant isolates [Enterobacterales, (39/40); P. aeruginosa (19/19); A. xylosoxidans (5/6); S. maltophilia (5/6); Burkholderia spp. (8/8)]. Disc diffusion showed a high CA (from 94.9 to 100%) regardless of disc manufacturer in Enterobacterales, P. aeuroginosa, A. baumannii and S. maltophilia. However, high rates of results falling in the area of technical uncertainty (ATU) were observed in Enterobacterales (34/90, 37.8%) and P. aeruginosa (16/40, 40%). Disc diffusion showed a poor performance in A. xylosoxidans and Burkholderia spp. if PK/PD breakpoint was used (overall, 5/9 VMEs; in contrast, the use of P. aeruginosa-specific breakpoints resulted in 100% of CA with 24.6% of results in the ATU).

Conclusion

In conclusion, disc diffusion and UMIC^® Cefiderocol are valid methods for the determination of cefiderocol susceptibility. Given the high number of results in the ATU by disc diffusion, a combined use of both AST methods may represent a solution to overcome the challenge of cefiderocol susceptibility testing in routine microbiology laboratories.

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Title: Performance evaluation of Bruker UMIC® microdilution panel and disc diffusion to determine cefiderocol susceptibility in Enterobacterales, Acinetobacter baumannii, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Achromobacter xylosoxidans and Burkolderia species
Authors: Gabriele Bianco
Matteo Boattini
Sara Comini
Paolo Gaibani
Rossana Cavallo
Cristina Costa
Publication date: 19-01-2024
Publisher: Springer Berlin Heidelberg
Keyword: Pseudomonas Aeruginosa
Published in: European Journal of Clinical Microbiology & Infectious Diseases / Issue 3/2024
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI: https://doi.org/10.1007/s10096-024-04745-7

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