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General consideration and application of information
for susceptibility testing


The antimicrobial agent that is appropriate for the
isolated bacterial; depended on




1- The drug of choice




2-The availability of reliable standardized methods of
testing the isolate




3-The clinical significance of a bacterial isolate




The clinical and
laboratory standards institute "-CLSI-" publishes up-to-date tables
of potential antimicrobial agents to include in batteries of testing against
particular organism or organism group


Individual testing batteries are considered for each
of the following groups


-
Enterobacteriaceae


-
Pseudomonas
and Acinetobacter spp


-
Staphylococcus
spp


-
Enterococcus
spp


-
Streptococcus
[not including S. pneumonia]


-
Streptococcus
pneumonia


-
Haemophilus
influenza


-
Neisseria
gonorrhea


-
Burkholderia
cepacia


-
Stenotrophomonas
maltophilia


-
Streptococcus
spp viridians group


The primary susceptibility test methods are either


1- Disk diffusion agar method, or


2- Disk diffusion agar method, or


3- Commercial either micro dilution or automation to
detection the MIC of organism.


The MIC [minimal inhibitory concentration] is the
lowest antimicrobial concentration that completely inhibits visible bacterial
growth as detected visually or via automated or semi automated methods.


So to evaluate the accuracy of susceptibility profile,
the identification of the organism must be known.


The susceptibility testing profiles produced for each
bacterial isolate are typically reported to the physician as a listing of
antimicrobial agents with each agent accompanied by the category interpretation
of susceptible, intermediate, or resistant.











The definition of susceptibility testing is:


susceptible:


This category indicates that the antimicrobial agent,
in question may be an appropriate for treating the infection caused by the
bacterial isolate tested.


Bacterial resistance is absent or at clinically
insignificant level


Intermediate:


This category is used to
indicate a number of possibilities including:


-
The potential utility of the antimicrobial agent in
body sites where it may be concentrated [e.g., the urinary tract] or if high
concentration of the drug are used


-
The antimicrobial agent may still be effective
against the tested isolate but possibly less so than against a susceptible
isolate.


Resistant:


This category indicates that
the antimicrobial agent in question may not be appropriate choice for treating, the infection caused by the
bacterial isolate tested, either because the organism is inhibited by serum-achievable
level of the drug or because the test result highly correlates with resistance
mechanism that renders treatment success doubtful.


The following tables show
the antimicrobial profile and available antimicrobial against isolated bacteria
during the period (from July 1st
to December 28th 2009) in
the medical city complex in Baghdad.


It can be a reference guide
to all Iraqi hospital as the medical city complex is the central medical
complex with the highest sophisticated ability in their labs. As will as the
fact that is complex has the highest drain from all over Iraq.


These tables will be updated
every six months according to the changes in our databases.


We hopes that the
information included in this papers are informative and beneficial for
physicians for the treatment of their patients

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