Consequences of switching from a fixed 2:1 ratio of amoxicillin/clavulanate (CLSI) to a fixed concentration of clavulanate (EUCAST) for susceptibility testing of Escherichia coli

Maurine A. Leverstein-van Hall; Karola Waar; Jan Muilwijk; ISIS-AR study group; James Cohen Stuart; L. J.M. Sabbeon; H. M.E. Frenay; B. Maraha; P. H.J. van Keulen; J. A.J.W. Kluytmans; B. M. de Jongh; B. J.M. Vlaminckx; E. I.G.B. De Brauwer; F. S. Stals; L. J. Bakker; J. W. Dorigo-Zetsma; F. W. Sebens; E. E. Mattsson; J. A. Kaan; S. F.T. Thijsen; A. G.M. Buiting; R. G.F. Wintermans; B. C. van Hees; R. W. Brimicombe; G. J.H.M. Ruijs; M. J. Wolfhagen; J. H. vanZeijl; K. Waar; N. H.M. Renders; A. T. Bernards; R. G.F. Wintermans; F. G.C. Heilmann; T. Halaby; B. P. Overbeek; J. F.P. Schellekens; C. L. Jansen; F. Vlaspolder; J. Alblas; A. K. van der Bij; T. Leenstra; M. A. Leverstein-van Hall; J. Monen; J. Muilwijk; H. T. Tjhie; P. D.J. Sturm; B. M. Diederen; A. A. van Zwet; M. P.D. Deege; C. H.E. Boel; J. Cohen Stuart; B. G.A. Hendrickx

doi:10.1093/jac/dkt218

Consequences of switching from a fixed 2:1 ratio of amoxicillin/clavulanate (CLSI) to a fixed concentration of clavulanate (EUCAST) for susceptibility testing of Escherichia coli

Maurine A. Leverstein-van Hall^*, Karola Waar, Jan Muilwijk, ISIS-AR study group, James Cohen Stuart, L. J.M. Sabbeon, H. M.E. Frenay, B. Maraha, P. H.J. van Keulen, J. A.J.W. Kluytmans, B. M. de Jongh, B. J.M. Vlaminckx, E. I.G.B. De Brauwer, F. S. Stals, L. J. Bakker, J. W. Dorigo-Zetsma, F. W. Sebens, E. E. Mattsson, J. A. Kaan, S. F.T. ThijsenA. G.M. Buiting, R. G.F. Wintermans, B. C. van Hees, R. W. Brimicombe, G. J.H.M. Ruijs, M. J. Wolfhagen, J. H. vanZeijl, K. Waar, N. H.M. Renders, A. T. Bernards, R. G.F. Wintermans, F. G.C. Heilmann, T. Halaby, B. P. Overbeek, J. F.P. Schellekens, C. L. Jansen, F. Vlaspolder, J. Alblas, A. K. van der Bij, T. Leenstra, M. A. Leverstein-van Hall^*, J. Monen, J. Muilwijk, H. T. Tjhie, P. D.J. Sturm, B. M. Diederen, A. A. van Zwet, M. P.D. Deege, C. H.E. Boel, J. Cohen Stuart, B. G.A. Hendrickx

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

19 Citations (Scopus)

Abstract

Objectives: The CLSI recommends a fixed 2:1 ratio of co-amoxiclav for broth microdilution susceptibility testing of Enterobacteriaceae, while EUCASTrecommends a fixed 2 mg/L clavulanate concentration. The aims of this study were: (i) to determine the influence of a switch fromCLSI to EUCASTmethodology on Escherichia coli susceptibility rates; (ii) to compare susceptibility results obtained using EUCAST-compliant microdilution with those from disc diffusion and the Etest; and (iii) to evaluate the clinical outcome of patients with E. coli sepsis treated with co-amoxiclav in relation to the susceptibility results obtained using either method. Methods: Resistance rateswere determined in three laboratories that switched fromCLSI to EUCASTcards with the Phoenix system (Becton Dickinson) as well as in 17 laboratories that continued to use CLSI cards with the VITEK 2 system (bioMérieux). In one laboratory, isolateswere simultaneously tested by both the Phoenix system and either disc diffusion (n=471) or the Etest (n=113). Medical and laboratory records were reviewed for E. coli sepsis patients treated with co-amoxiclav monotherapy. Results: Only laboratories that switched methodology showed an increase in resistance rates - from19% in 2010 to 31% in 2011 (P,0.0001). All isolates that tested susceptible by microdilution were also susceptible by disc diffusion or the Etest, but of 326 isolates that tested resistant by microdilution, 43% and 59% tested susceptible by disc diffusion and the Etest, respectively. Among the 89 patients included there was a better correlation between clinical response and measured MICs using the Phoenix system than the Etest. Conclusions: EUCASTmethodology resulted in higherco-amoxiclav E. coli resistance rates than CLSI methodology, but correlated better with clinical outcome. EUCAST-compliant microdilution and disc diffusion provided discrepant results.

Original language	English
Article number	dkt218
Pages (from-to)	2636-2640
Number of pages	5
Journal	Journal of Antimicrobial Chemotherapy
Volume	68
Issue number	11
DOIs	https://doi.org/10.1093/jac/dkt218
Publication status	Published - Nov 2013
Externally published	Yes

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Leverstein-van Hall, M. A., Waar, K., Muilwijk, J., ISIS-AR study group, Stuart, J. C., Sabbeon, L. J. M., Frenay, H. M. E., Maraha, B., van Keulen, P. H. J., Kluytmans, J. A. J. W., de Jongh, B. M., Vlaminckx, B. J. M., De Brauwer, E. I. G. B., Stals, F. S., Bakker, L. J., Dorigo-Zetsma, J. W., Sebens, F. W., Mattsson, E. E., Kaan, J. A., ... Hendrickx, B. G. A. (2013). Consequences of switching from a fixed 2:1 ratio of amoxicillin/clavulanate (CLSI) to a fixed concentration of clavulanate (EUCAST) for susceptibility testing of Escherichia coli. Journal of Antimicrobial Chemotherapy, 68(11), 2636-2640. Article dkt218. https://doi.org/10.1093/jac/dkt218

@article{b33957ba35ed4a57a3426d6f30e1f3c0,

title = "Consequences of switching from a fixed 2:1 ratio of amoxicillin/clavulanate (CLSI) to a fixed concentration of clavulanate (EUCAST) for susceptibility testing of Escherichia coli",

abstract = "Objectives: The CLSI recommends a fixed 2:1 ratio of co-amoxiclav for broth microdilution susceptibility testing of Enterobacteriaceae, while EUCASTrecommends a fixed 2 mg/L clavulanate concentration. The aims of this study were: (i) to determine the influence of a switch fromCLSI to EUCASTmethodology on Escherichia coli susceptibility rates; (ii) to compare susceptibility results obtained using EUCAST-compliant microdilution with those from disc diffusion and the Etest; and (iii) to evaluate the clinical outcome of patients with E. coli sepsis treated with co-amoxiclav in relation to the susceptibility results obtained using either method. Methods: Resistance rateswere determined in three laboratories that switched fromCLSI to EUCASTcards with the Phoenix system (Becton Dickinson) as well as in 17 laboratories that continued to use CLSI cards with the VITEK 2 system (bioM{\'e}rieux). In one laboratory, isolateswere simultaneously tested by both the Phoenix system and either disc diffusion (n=471) or the Etest (n=113). Medical and laboratory records were reviewed for E. coli sepsis patients treated with co-amoxiclav monotherapy. Results: Only laboratories that switched methodology showed an increase in resistance rates - from19% in 2010 to 31% in 2011 (P,0.0001). All isolates that tested susceptible by microdilution were also susceptible by disc diffusion or the Etest, but of 326 isolates that tested resistant by microdilution, 43% and 59% tested susceptible by disc diffusion and the Etest, respectively. Among the 89 patients included there was a better correlation between clinical response and measured MICs using the Phoenix system than the Etest. Conclusions: EUCASTmethodology resulted in higherco-amoxiclav E. coli resistance rates than CLSI methodology, but correlated better with clinical outcome. EUCAST-compliant microdilution and disc diffusion provided discrepant results.",

author = "{Leverstein-van Hall}, {Maurine A.} and Karola Waar and Jan Muilwijk and {ISIS-AR study group} and Stuart, {James Cohen} and Sabbeon, {L. J.M.} and Frenay, {H. M.E.} and B. Maraha and {van Keulen}, {P. H.J.} and Kluytmans, {J. A.J.W.} and {de Jongh}, {B. M.} and Vlaminckx, {B. J.M.} and {De Brauwer}, {E. I.G.B.} and Stals, {F. S.} and Bakker, {L. J.} and Dorigo-Zetsma, {J. W.} and Sebens, {F. W.} and Mattsson, {E. E.} and Kaan, {J. A.} and Thijsen, {S. F.T.} and Buiting, {A. G.M.} and Wintermans, {R. G.F.} and {van Hees}, {B. C.} and Brimicombe, {R. W.} and Ruijs, {G. J.H.M.} and Wolfhagen, {M. J.} and vanZeijl, {J. H.} and K. Waar and Renders, {N. H.M.} and Bernards, {A. T.} and Wintermans, {R. G.F.} and Heilmann, {F. G.C.} and T. Halaby and Overbeek, {B. P.} and Schellekens, {J. F.P.} and Jansen, {C. L.} and F. Vlaspolder and J. Alblas and {van der Bij}, {A. K.} and T. Leenstra and {Leverstein-van Hall}, {M. A.} and J. Monen and J. Muilwijk and Tjhie, {H. T.} and Sturm, {P. D.J.} and Diederen, {B. M.} and {van Zwet}, {A. A.} and Deege, {M. P.D.} and Boel, {C. H.E.} and {Cohen Stuart}, J. and Hendrickx, {B. G.A.}",

year = "2013",

month = nov,

doi = "10.1093/jac/dkt218",

language = "English",

volume = "68",

pages = "2636--2640",

journal = "Journal of Antimicrobial Chemotherapy",

issn = "0305-7453",

publisher = "Oxford University Press",

number = "11",

}

Leverstein-van Hall, MA, Waar, K, Muilwijk, J, ISIS-AR study group, Stuart, JC, Sabbeon, LJM, Frenay, HME, Maraha, B, van Keulen, PHJ, Kluytmans, JAJW, de Jongh, BM, Vlaminckx, BJM, De Brauwer, EIGB, Stals, FS, Bakker, LJ, Dorigo-Zetsma, JW, Sebens, FW, Mattsson, EE, Kaan, JA, Thijsen, SFT, Buiting, AGM, Wintermans, RGF, van Hees, BC, Brimicombe, RW, Ruijs, GJHM, Wolfhagen, MJ, vanZeijl, JH, Waar, K, Renders, NHM, Bernards, AT, Wintermans, RGF, Heilmann, FGC, Halaby, T, Overbeek, BP, Schellekens, JFP, Jansen, CL, Vlaspolder, F, Alblas, J, van der Bij, AK, Leenstra, T, Leverstein-van Hall, MA, Monen, J, Muilwijk, J, Tjhie, HT, Sturm, PDJ, Diederen, BM, van Zwet, AA, Deege, MPD, Boel, CHE, Cohen Stuart, J & Hendrickx, BGA 2013, 'Consequences of switching from a fixed 2:1 ratio of amoxicillin/clavulanate (CLSI) to a fixed concentration of clavulanate (EUCAST) for susceptibility testing of Escherichia coli', Journal of Antimicrobial Chemotherapy, vol. 68, no. 11, dkt218, pp. 2636-2640. https://doi.org/10.1093/jac/dkt218

Consequences of switching from a fixed 2:1 ratio of amoxicillin/clavulanate (CLSI) to a fixed concentration of clavulanate (EUCAST) for susceptibility testing of Escherichia coli. / Leverstein-van Hall, Maurine A.; Waar, Karola; Muilwijk, Jan et al.
In: Journal of Antimicrobial Chemotherapy, Vol. 68, No. 11, dkt218, 11.2013, p. 2636-2640.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Consequences of switching from a fixed 2:1 ratio of amoxicillin/clavulanate (CLSI) to a fixed concentration of clavulanate (EUCAST) for susceptibility testing of Escherichia coli

AU - Leverstein-van Hall, Maurine A.

AU - Waar, Karola

AU - Muilwijk, Jan

AU - ISIS-AR study group

AU - Stuart, James Cohen

AU - Sabbeon, L. J.M.

AU - Frenay, H. M.E.

AU - Maraha, B.

AU - van Keulen, P. H.J.

AU - Kluytmans, J. A.J.W.

AU - de Jongh, B. M.

AU - Vlaminckx, B. J.M.

AU - De Brauwer, E. I.G.B.

AU - Stals, F. S.

AU - Bakker, L. J.

AU - Dorigo-Zetsma, J. W.

AU - Sebens, F. W.

AU - Mattsson, E. E.

AU - Kaan, J. A.

AU - Thijsen, S. F.T.

AU - Buiting, A. G.M.

AU - Wintermans, R. G.F.

AU - van Hees, B. C.

AU - Brimicombe, R. W.

AU - Ruijs, G. J.H.M.

AU - Wolfhagen, M. J.

AU - vanZeijl, J. H.

AU - Waar, K.

AU - Renders, N. H.M.

AU - Bernards, A. T.

AU - Wintermans, R. G.F.

AU - Heilmann, F. G.C.

AU - Halaby, T.

AU - Overbeek, B. P.

AU - Schellekens, J. F.P.

AU - Jansen, C. L.

AU - Vlaspolder, F.

AU - Alblas, J.

AU - van der Bij, A. K.

AU - Leenstra, T.

AU - Leverstein-van Hall, M. A.

AU - Monen, J.

AU - Muilwijk, J.

AU - Tjhie, H. T.

AU - Sturm, P. D.J.

AU - Diederen, B. M.

AU - van Zwet, A. A.

AU - Deege, M. P.D.

AU - Boel, C. H.E.

AU - Cohen Stuart, J.

AU - Hendrickx, B. G.A.

PY - 2013/11

Y1 - 2013/11

N2 - Objectives: The CLSI recommends a fixed 2:1 ratio of co-amoxiclav for broth microdilution susceptibility testing of Enterobacteriaceae, while EUCASTrecommends a fixed 2 mg/L clavulanate concentration. The aims of this study were: (i) to determine the influence of a switch fromCLSI to EUCASTmethodology on Escherichia coli susceptibility rates; (ii) to compare susceptibility results obtained using EUCAST-compliant microdilution with those from disc diffusion and the Etest; and (iii) to evaluate the clinical outcome of patients with E. coli sepsis treated with co-amoxiclav in relation to the susceptibility results obtained using either method. Methods: Resistance rateswere determined in three laboratories that switched fromCLSI to EUCASTcards with the Phoenix system (Becton Dickinson) as well as in 17 laboratories that continued to use CLSI cards with the VITEK 2 system (bioMérieux). In one laboratory, isolateswere simultaneously tested by both the Phoenix system and either disc diffusion (n=471) or the Etest (n=113). Medical and laboratory records were reviewed for E. coli sepsis patients treated with co-amoxiclav monotherapy. Results: Only laboratories that switched methodology showed an increase in resistance rates - from19% in 2010 to 31% in 2011 (P,0.0001). All isolates that tested susceptible by microdilution were also susceptible by disc diffusion or the Etest, but of 326 isolates that tested resistant by microdilution, 43% and 59% tested susceptible by disc diffusion and the Etest, respectively. Among the 89 patients included there was a better correlation between clinical response and measured MICs using the Phoenix system than the Etest. Conclusions: EUCASTmethodology resulted in higherco-amoxiclav E. coli resistance rates than CLSI methodology, but correlated better with clinical outcome. EUCAST-compliant microdilution and disc diffusion provided discrepant results.

AB - Objectives: The CLSI recommends a fixed 2:1 ratio of co-amoxiclav for broth microdilution susceptibility testing of Enterobacteriaceae, while EUCASTrecommends a fixed 2 mg/L clavulanate concentration. The aims of this study were: (i) to determine the influence of a switch fromCLSI to EUCASTmethodology on Escherichia coli susceptibility rates; (ii) to compare susceptibility results obtained using EUCAST-compliant microdilution with those from disc diffusion and the Etest; and (iii) to evaluate the clinical outcome of patients with E. coli sepsis treated with co-amoxiclav in relation to the susceptibility results obtained using either method. Methods: Resistance rateswere determined in three laboratories that switched fromCLSI to EUCASTcards with the Phoenix system (Becton Dickinson) as well as in 17 laboratories that continued to use CLSI cards with the VITEK 2 system (bioMérieux). In one laboratory, isolateswere simultaneously tested by both the Phoenix system and either disc diffusion (n=471) or the Etest (n=113). Medical and laboratory records were reviewed for E. coli sepsis patients treated with co-amoxiclav monotherapy. Results: Only laboratories that switched methodology showed an increase in resistance rates - from19% in 2010 to 31% in 2011 (P,0.0001). All isolates that tested susceptible by microdilution were also susceptible by disc diffusion or the Etest, but of 326 isolates that tested resistant by microdilution, 43% and 59% tested susceptible by disc diffusion and the Etest, respectively. Among the 89 patients included there was a better correlation between clinical response and measured MICs using the Phoenix system than the Etest. Conclusions: EUCASTmethodology resulted in higherco-amoxiclav E. coli resistance rates than CLSI methodology, but correlated better with clinical outcome. EUCAST-compliant microdilution and disc diffusion provided discrepant results.

UR - http://www.scopus.com/inward/record.url?scp=84886284337&partnerID=8YFLogxK

U2 - 10.1093/jac/dkt218

DO - 10.1093/jac/dkt218

M3 - Article

C2 - 23766488

AN - SCOPUS:84886284337

SN - 0305-7453

VL - 68

SP - 2636

EP - 2640

JO - Journal of Antimicrobial Chemotherapy

JF - Journal of Antimicrobial Chemotherapy

IS - 11

M1 - dkt218

ER -

Leverstein-van Hall MA, Waar K, Muilwijk J, ISIS-AR study group, Stuart JC, Sabbeon LJM et al. Consequences of switching from a fixed 2:1 ratio of amoxicillin/clavulanate (CLSI) to a fixed concentration of clavulanate (EUCAST) for susceptibility testing of Escherichia coli. Journal of Antimicrobial Chemotherapy. 2013 Nov;68(11):2636-2640. dkt218. doi: 10.1093/jac/dkt218

Consequences of switching from a fixed 2:1 ratio of amoxicillin/clavulanate (CLSI) to a fixed concentration of clavulanate (EUCAST) for susceptibility testing of Escherichia coli

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