Modification of interpretive breakpoints for netilmicin disk susceptibility tests with Pseudomonas aeruginosa

Abstract

Regression analysis of data correlating 30-micrograms netilmicin disk zone diameters with microdilution MICs, obtained by testing close-interval dilution steps, was performed with 77 selected strains of Pseudomonas aeruginosa, each tested in three independent laboratories. A zone of greater than or equal to 15 mm correlated with an MIC of less than or equal to 12 micrograms/ml (susceptible), and a zone of less than or equal to 12 mm correlated with an MIC of greater than 16 micrograms/ml (resistant). Additional disk tests were performed with 256 strains having known resistance mechanisms and 280 susceptible strains: the majority were appropriately categorized by these interpretive zone standards. The previously recommended standards of greater than or equal to 17 mm (MIC, less than or equal to 8.0 micrograms/ml) for the susceptible category inappropriately placed a significant number of truly susceptible P. aeruginosa strains in the intermediate category.