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IP International Journal of Medical Microbiology and Tropical Diseases


Direct reporting cefazolin from VITEK 2 for E. coli, K. pneumoniae and P. mirabilis isolated from urine cultures using new CLSI interpretations


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Author Details: Jianhui Xiong, Bradley Langford, Sigmund Krajden, Zafar Hussain, David Hancock, Mark Downing, Willia

Volume : 2

Issue : 2

Online ISSN : 2581-4761

Print ISSN : 2581-4753

Article First Page : 42

Article End Page : 47


Abstract

Background: In recent years, Clinical and Laboratory Standard Institute (CLSI) has recommended a series breakpoint changes for cefazolin, including testing it as a surrogate agent for oral cephalosporins for treating uncomplicated urinary tract infections (uUTIs).
Objectives: This study was conducted to evaluate the feasibility of direct reporting the cefazolin results from VITEKÒ 2 for E. coli, K. pneumoniae, K. oxytoca and P. mirabilis isolated from patients with uUTIs using 2014 CLSI recommendation.
Material and Methods: Cefazolin susceptibility results of urine cultures of the above four species generated from January 1, 2013 December 31, 2013, using both GN AST card N208 on VITEKÒ 2 and cefazolin disk (gold standard) methods, were extracted from SoftMic Laboratory Information System and analyzed for their category agreement using 2014 CLSI interpretations.
Results: Cefazolin susceptibilities of 1969 urinary isolates (1869 patients) of E. coli, K. pneumoniae/K. oxytoca and P. mirabilis comparing their VITEKÒ 2 and disk test results, category agreement for cefazolin tested with both methods was 98%. The linear correlation between sensitive cefazolin and sensitive cephalothin MICs versus cefazolin zone diameters was good, with a predictive value of 99%.
Conclusion: It is acceptable to report cefazolin directly from VITEKÒ 2 for the named species from urine cultures. The susceptibility correlation among cefazolin, cephalothin and cefixime were excellent (excluded non-susceptible), further testing with individual oral cephalosporin agents, in this institute, may not be necessary.
Recommendation: Final report accompanied by a comment in accordance with 2014 CLSI guideline is recommended to provide therapeutic guidance to clinicians.

Key Word
: Cefazolin, Urine Culture, CLSI, Interpretations, VITEKÒ 2