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Explore the significance of in vitro antibiotic testing on bacterial cultures to guide treatment decisions & understand resistance patterns. Discover methodologies like Kirby-Bauer & MIC for optimal therapy selection.
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The in vitro testing of bacterial cultures with antibiotics todetermine . K Hari Krishnan TirunelveliMedical College
Antibiotic Sensitivity Testing K Hari Krishnan TirunelveliMedical College
To guide the clinician in selecting the best antibiotic agent for an individualpatient. To control the useof in clinicalpractice. To accumulate epidemiological information on the resistance of microorganisms of public health importance within thecommunity. To reveal the changing trends inthe localisolates. K Hari Krishnan TirunelveliMedical College
Bacteria have the ability to develop resistance following repeated or subclinical (insufficient) doses, so more advanced antibiotics and synthetic antibiotics are continually required to overcomethem. K Hari Krishnan TirunelveliMedical College
AST is essential for the selection ofthe K Hari Krishnan TirunelveliMedical College
For the testing of isolates from “healthy” patientswith intact immunedefenses. • For such asuncomplicated • urinary tractinfections. • In the treatment of serious infections such as endocarditis orosteomyelitis. • For infections in high-risk patient groups such as immunocompromised patients (e.g..transplant patients). – Those who are criticallyill. K Hari Krishnan TirunelveliMedical College
Antibiotic SensitivityTests Diffusion & Dilution Diffusion Dilution Kirby-Bauer Method Stokes Method Tube Dilution Agar Dilution E-Test QualitativeMethods QuantitativeMethods K Hari Krishnan TirunelveliMedical College
Enterobacteriaceae Pseudomonas aeruginosa Staphylococcus Blood& Tissues Intestinal Urinary Benzylpenicillin Oxacillin Erythromycin Tetracycline Chloramphenicol Ampicillin Chloramphenicol Cotrimoxazole Tetracycline Sulfonamides Trimethoprim Cotrimoxazole Ampicillin Nitrofurantoin Tetracycline Ampicillin Chloramphenicol Cotrimoxazole Tetracycline Cefalotin Gentamycin Piperacillin Gentamycin Tobramycin Drugs K Hari Krishnan TirunelveliMedical College
– A paper disk with a defined amount of antibiotic is used to generate a dynamically changing gradient of antibiotic concentrations in the agar in the vicinity of thedisk. K Hari Krishnan TirunelveliMedical College
The allowedto contained in a reservoiris and interact in a plate freshly seeded with the test organisms. The disk is applied to the surface of an agar plate inoculated with the test organism. • The • gradient. • The diffuses out of the disk to form starts to divide and growand progresses toward a critical mass ofcells. K Hari Krishnan TirunelveliMedical College
is formed at the critical time where a particular concentration of the antibiotic is just able to inhibit the organism before it reaches an overwhelming cell mass or criticalmass. K Hari Krishnan TirunelveliMedical College
Any commercially available discs with the proper diameter and potency can beused. Stocks of antibiotic discs can be storedat -20 ⁰C for 1month. – On removal from the refrigerator, the containers should be left at room temperature for about 1 hour to allow the temperature toequilibrate. K Hari Krishnan TirunelveliMedical College
Used to determinethe of antibiotic to inhibit or killthe microorganism. Achieved by dilution of antibiotic in either agar or brothmedia. K Hari Krishnan TirunelveliMedical College
The lowest concentration of drugthat of thebacteria isolated from thepatient. The MIC is determined by inoculating the organism isolated from the patient into a series of tubes or cups containing progressive dilutions of thedrug. K Hari Krishnan TirunelveliMedical College
Patient's organism is added to tubes containing decreasing amounts of the antibiotic Incubation At 37°Covernight Lowest concentration of drug that inhibits growth is theMIC K Hari Krishnan TirunelveliMedical College
MIC K Hari Krishnan TirunelveliMedical College
The lowest concentration of drugthat the bacteria isolated from thepatient. K Hari Krishnan TirunelveliMedical College
Serial dilutions of the drug are prepared in agar and poured intoplates. – Many strains can be inoculated on each plate containing an antibioticdilution. K Hari Krishnan TirunelveliMedical College
Broth microdilution platecontains – Eachrow: • standard dilutions ofeight by lettersA-H). • – Eachcolumn in each row(denoted • containsastandard concentration that doubles whenmoving from right toleft. • The minimum inhibitory concentration (MIC) is determined by the first well where there is no visiblegrowth. K Hari Krishnan TirunelveliMedical College
EpsilometerTest Quantitative method of antibiotic sensitivity testing. Applies both dilution of antibiotic and diffusion of antibiotic into themedium. K Hari Krishnan TirunelveliMedical College
Combines the principles of disk diffusion and agar dilutionmethods Diffusion E-Test Dilution K Hari Krishnan TirunelveliMedical College
A predefined stable antibiotic gradient is present on a thin inert carrierstrip. Using innovative dry chemistry technology, E-Test is used to determine the on-scale Minimum Inhibitory Concentration(MIC). K Hari Krishnan TirunelveliMedical College
The intersection of the inhibitory zone edge and the calibrated carrier strip indicates the MIC withinherent K Hari Krishnan TirunelveliMedical College precision andaccuracy.
MIC K Hari Krishnan TirunelveliMedical College
Over100 are now available in the product range for testing of aerobic bacteria and fastidious organisms suchas • Pneumococci • Haemophilus • Helicobacter pylori • Meningococci • Gonococci • Fungi • Mycobacteria K Hari Krishnan TirunelveliMedical College
Antibiotic SensitivityTesting K Hari Krishnan TirunelveliMedical College