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  • Title: Determination of trimethoprim-sulfamethoxazole resistance in Streptococcus pneumoniae by using the E test with Mueller-Hinton agar supplemented with sheep or horse blood may be unreliable. The Pneumococcal Study Group.
    Author: Lovgren M, Dell'Acqua L, Palacio R, Echániz-Aviles G, Soto-Noguerón A, Castañeda E, Agudelo CI, Heitmann I, Brandileone MC, Zanella RC, Rossi A, Pace J, Talbot JA.
    Journal: J Clin Microbiol; 1999 Jan; 37(1):215-7. PubMed ID: 9854095.
    Abstract:
    An international, multicenter study compared trimethoprim-sulfamethoxazole MICs for 743 Streptococcus pneumoniae isolates (107 to 244 isolates per country) by E test, using Mueller-Hinton agar supplemented with 5% defibrinated horse blood or 5% defibrinated sheep blood, with MICs determined by the National Committee for Clinical Laboratory Standards broth microdilution reference method. Agreement within 1 log2 dilution and minor error rates were 69.3 and 15.5%, respectively, on sheep blood-supplemented agar and 76.9 and 13.6%, respectively, with horse blood as the supplement. Significant interlaboratory variability was observed. E test may not be a reliable method for determining the resistance of pneumococci to trimethoprim-sulfamethoxazole.
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