1. Evaluation of an expert system linked to a rapid antibiotic susceptibility testing system for the detection of β-lactam resistance phenotypes
- Author
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Flandrois, Jean-Pierre, Vedel, G., Peyret, M., Gayral, J.P., Millot, Patrick, Bioinformatique, phylogénie et génomique évolutive (BPGE), Département PEGASE [LBBE] (PEGASE), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), and Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)
- Subjects
food.ingredient ,medicine.drug_class ,Antibiotics ,Expert Systems ,In Vitro Techniques ,beta-Lactams ,[SDV.BID.SPT]Life Sciences [q-bio]/Biodiversity/Systematics, Phylogenetics and taxonomy ,Microbiology ,03 medical and health sciences ,Minimum inhibitory concentration ,[SDV.EE.ECO]Life Sciences [q-bio]/Ecology, environment/Ecosystems ,0302 clinical medicine ,food ,Enterobacteriaceae ,medicine ,Agar ,030212 general & internal medicine ,Molecular Biology ,ComputingMilieux_MISCELLANEOUS ,Antibacterial agent ,Bacteriological Techniques ,0303 health sciences ,biology ,030306 microbiology ,[SDV.BID.EVO]Life Sciences [q-bio]/Biodiversity/Populations and Evolution [q-bio.PE] ,Drug Resistance, Microbial ,General Medicine ,biology.organism_classification ,[SDV.BIBS]Life Sciences [q-bio]/Quantitative Methods [q-bio.QM] ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,Phenotype ,Anti-Bacterial Agents ,Bacteria ,Antibiotic disc - Abstract
Interpretive reading of antibiotic disc agar diffusion tests indicates the resistance mechanisms, if any, expressed by a bacterium. An expert system for determining resistance mechanisms using rapid automated antibiotic susceptibility tests has been developed. The β-lactan susceptibility of each of 300 strains of clinically significant species of enterobacteria, displaying natural and acquired resistance mechanisms, was determined by disc agar diffusion and by a rapid automated method of susceptibility testing associated with an expert system. For every strain, the conclusion of the expert analysis of the automated test was compared with the commonly accepted interpretation of disc agar diffusion tests. Of the 300 strains studied, 275 were similarly interpreted (91.7% agreement). The susceptible and naturally β-lactan-resistant phenotypes (wild phenotypes) were equally recognized by both methods. Similarly, the results of the two methods concurred for most of the acquired resistance phenotypes. However, for 25 strains (8.3%) the results diverged. The expert system proposed an erroneous phenotype (5 strains), several phenotypes including the correct one (17 strains), or no phenotype (1 strain). For 2 strains the natural resistance mechanism was not detected at first by the automated method but was subsequently deduced by the expert analysis according to bacterial identification. These results demonstrate that satisfactory interpretive reading of automated antibiotic susceptibility tests is possible in 4 to 5 hours but requires careful selection of the antibiotics tested as phenotypic markers.
- Published
- 1996
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