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Title: A multi-site, international laboratory study to assess the performance of penicillin susceptibility testing of Staphylococcus aureus.
Austin Authors: Henderson, Andrew;Cheng, Matthew P;Chew, Ka Lip;Coombs, Geoffrey W;Davis, Joshua S;Grant, Jennifer M;Gregson, Dan;Giulieri, Stefano G ;Howden, Benjamin P ;Lee, Todd C;Nguyen, Vi;Mora, Jocelyn M;Morpeth, Susan C;Robinson, James O;Tong, Steven Y C;Van Hal, Sebastiaan J
Affiliation: Infection Management Services, Princess Alexandra Hospital, Brisbane, Australia.
Department of Medicine, and Laboratory Medicine, McGill University Health Centre, Montreal, Canada.
Department of Laboratory Medicine, National University Hospital, Singapore, Singapore.
Department of Antimicrobial Resistance, and Infectious Diseases Research Laboratory, Murdoch University, Murdoch, Australia.
Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.;Department of Infectious Diseases, John Hunter Hospital, Newcastle, Australia.
Department of Medicine, Vancouver Coastal Health, Vancouver, Canada.;Department of Medicine, University of British Columbia, Vancouver, Canada.
Department of Pathology, Laboratory Medicine, and Medicine, Cummings School of Medicine at The University of Calgary, Calgary, Canada.
Department of Microbiology, and Immunology, The University of Melbourne, Melbourne, Australia.;Victorian Infectious Diseases Services, The Royal Melbourne Hospital, Melbourne, Australia.
Microbiological Diagnostic Unit Public Health Laboratory, The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.;Department of Infectious Diseases, Austin Hospital, Heidelberg, Australia.
Department of Medicine, McGill University, Montreal, Canada.
Infectious Diseases
The Peter Doherty Institute
Microbiology Laboratory, Middlemore Hospital (Counties Manukau Te Whatu Ora), Otahuhu, New Zealand.;Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Department of Infectious Diseases, Royal Perth Hospital, Perth, Australia.;Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch, Australia.
Department of Microbiology, and Infectious Diseases, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Sydney, Australia.;School of Medicine, The University of Sydney, Sydney, Australia.
Issue Date: 1-Jun-2023
Date: 2023
Publication information: The Journal of Antimicrobial Chemotherapy 2023-06-01; 78(6)
Abstract: There is clinical uncertainty over the optimal treatment for penicillin-susceptible Staphylococcus aureus (PSSA) infections. Furthermore, there is concern that phenotypic penicillin susceptibility testing methods are not reliably able to detect some blaZ-positive S. aureus. Nine S. aureus isolates, including six genetically diverse strains harbouring blaZ, were sent in triplicate to 34 participating laboratories from Australia (n = 14), New Zealand (n = 6), Canada (n = 12), Singapore (n = 1) and Israel (n = 1). We used blaZ PCR as the gold standard to assess susceptibility testing performance of CLSI (P10 disc) and EUCAST (P1 disc) methods. Very major errors (VMEs), major error (MEs) and categorical agreement were calculated. Twenty-two laboratories reported 593 results according to CLSI methodology (P10 disc). Nineteen laboratories reported 513 results according to the EUCAST (P1 disc) method. For CLSI laboratories, the categorical agreement and calculated VME and ME rates were 85% (508/593), 21% (84/396) and 1.5% (3/198), respectively. For EUCAST laboratories, the categorical agreement and calculated VME and ME rates were 93% (475/513), 11% (84/396) and 1% (3/198), respectively. Seven laboratories reported results for both methods, with VME rates of 24% for CLSI and 12% for EUCAST. The EUCAST method with a P1 disc resulted in a lower VME rate compared with the CLSI methods with a P10 disc. These results should be considered in the context that among collections of PSSA isolates, as determined by automated MIC testing, less than 10% harbour blaZ. Furthermore, the clinical relevance of phenotypically susceptible, but blaZ-positive S. aureus, remains unclear.
DOI: 10.1093/jac/dkad116
ORCID: 0000-0002-4867-2063
Journal: The Journal of Antimicrobial Chemotherapy
PubMed URL: 37071589
ISSN: 1460-2091
Type: Journal Article
Appears in Collections:Journal articles

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