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- W2318888962 abstract "Viridans streptococci (VS) causing bacterial endocarditis are frequently tolerant to penicillin (MIC:MBC ratio ≥ 32) and a treatment combination of a penicillin and an aminoglycoside is commonly used. If the absence of tolerance could be simply and rapidly determined, there is an option of ceasing or shortening the duration of aminoglycoside therapy in patients where toxicity from this group of drugs is of concern. Determination of the MIC and MBC of VS causing endocarditis has traditionally required labour intensive broth dilution methods. MBC estimations have been poorly standardised are subject to technical error and available in few laboratories. A new method, the “E-Test” (AB Biodisk) allows the simple and accurate determination of MIC’s. A modification of this method to enable the determination of tolerance was developed. Following estimation of the MIC residual penicillin was inactivated with Beta-lactamase delivered by a measured dose spray, the plate reincubated and surviving organisms in a specified area counted. Forty VS isolates from cases of proven endocarditis were examined for tolerance using the “E-Test” and traditional micro and macro broth dilution methods (NCCSLS M7-T2 and M26-P). The “E-Test” method compared very favourably, was relatively non-labour intensive, less subject to technical error and should be able to be performed by most microbiology laboratories." @default.
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- W2318888962 date "1992-01-01" @default.
- W2318888962 modified "2023-09-28" @default.
- W2318888962 title "Penicillin tolerance in viridans streptococci causing endocarditis - A novel detection method employing the “E-Test”" @default.
- W2318888962 doi "https://doi.org/10.1016/s0031-3025(16)36024-x" @default.
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