Reliability of Disc Diffusion Susceptibility Testing

Abstract

AbstractWe retested 2,181 bacteria-antibiotic combinations with the Kirby-Bauer disc-diffusion technique and found interpretive changes with 120 (5.5%). Most changes (101 of 120) were single steps (i.e. from R to I, I to R or S, or S to I). Of the 19 remaining, 10 of them were from R to Sand nine from S to R. These changes were significantly more frequent for combinations with zone diameters clustered near interpretive breakpoints (within 2mm) than for other combinations, and there was a linear relationship between decreased reproducibility and increased clustering near interpretive breakpoints.Based on an analysis of all susceptibility testing results performed in 1978, combinations most commonly clustered near interpretive breakpoints included: Ampicillin with Klebsiella pneumoniae; erythromycin with enterococci; chloramphenicol with Serratia marcescens; gentamicin with Pseudomonas aeruginosa and enterocci; and tetracycline with Enterobacter spp., Escherichia coli, and K. pneumoniae.