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Antimicrobial Susceptibility Testing: Critical Issues for by James A. Poupard, Lori R. Walsh, Bruce Kleger

By James A. Poupard, Lori R. Walsh, Bruce Kleger

The papers assembled during this assortment contain a majority of the oral shows in addition to a number of poster displays given on the twenty second Annual Symposium prepared through the Bastern Pennsylvania department of the yank Society for MicrobioloS)'. The symposium wouldn't be attainable with out the beneficiant help of the numerous sponsors (see sponsor record) or with out the concerted attempt of a11 the Committee individuals. This Symposium sequence has developed into an annual Bastern Pennsylvania department ASM occasion that pulls contributors from a large geographie sector. it's going to be famous that one of many hallmarks of those symposia consists of interplay among the presenters and people in attendance. numerous authors have altered their by means of the individuals. for that reason, the manuscript that manuscripts in line with reviews fo11ows might be seen as a gaggle attempt of either the contributors and presenters. J ames Poupard Lori Walsh Bruee Kleger ix CONTENTS 1 advent 1: present equipment The Evolution of Antimicrobial Susceptibility checking out tools . . . . . . . . . . . . . . . three James A. Poupard, Stephen F. Rittenhouse, and Lori R. Walsh Antimicrobial Susceptibility assessments: checking out tools and Interpretive difficulties. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Patrick R. Murray Clinician usage of quick Antibiotic Susceptibility facts: A potential learn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Franklin P. Koontz consultation 2: modern concerns IN SUSCEPTIBILITY checking out after we may be trying out, How frequently and What to document . . . . . . . . . . . . . . . 35 Raymond C. Bartlett parts of contemporary Emphasis of the nationwide Committee for medical Laboratory criteria Subcommittee on Antimicrobial Susceptibility trying out . . . . . . . . . . . . . . . . . . . . . . . sixty one James H. Jorgensen Non-Traditional ways for quality controls of Antimicrobial Susceptibility checks . . . . . . . . . . . . . . . . . . . . . . . . .

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J Clin Microbiol 29:2595-2598 (1991). Washington JA Discrepancies between In Vitro Activity of and In Vivo Response to Antimicrobial Agents, Diagn Microbiol Infect Dis 1:25-~1 (1983). Woolfrey BF, RT Lally, MN Ederer. Evaluation of the AutoMicrobic System for Detection of Resistance of Staphylococcus aureus to Methicillin. 1 Clin Microbiol 19:464-467 (1984). 25 CLINICIAN UTILIZATION OF RAPID ANTIBIOTIC SUSCEPTIBILITY DATA: A PROSPECTIVE STUDY Franklin P. Koontz University of Iowa Hospitals, Iowa City, Iowa INTRODUCTION The University of Iowa Hospitals is a 1,000 bed tertiary care center which serves as a regional hospital for hematology-oncology, cystic fibrosis and a variety of chronic disease patients.

The cost effectiveness of the tests is difficult to assess because instrument and consumable material costs, as weIl as personnel expenses, will vary widely. It was estimated that 20 million susceptibility tests were performed in 1990, with 30% by disk diffusion and the remainder by microdilution methods (Table 5). This represents a market of approximately $66,400,000. Despite a unit sales volume of 30%, the disk diffusion tests accounted for only $9,000,000 of sales or 14% of the market. 50 for the combination identification and susceptibility test tray.

This will be a more rapid and less costly means of directing appropriate therapy than spending several days and much laboratory effort on the isolation and susceptibility testing of only that portion of the microbial population that can be isolated in pure culture. Here again, culture and reporting of only the predominating isolate is misleading. The finding of end to end pairs of slender evenly staining gram negative rods suggestive of Pseudomonas should be reported and these specimens should be cultured because of the resistance that this organism usually displays and the impact that its presence often has on selection of therapy.

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