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Comment
. 2011 Sep;55(9):4492-3; author reply 4493.
doi: 10.1128/AAC.00232-11.

Wild-type MIC distributions must be considered to set clinically meaningful susceptibility testing breakpoints for all bacterial pathogens, including Mycobacterium tuberculosis

Kristian Angeby, Christian G Giske, Pontus Juréen, Thomas Schön, Jotam G Pasipanodya, Tawando Gumbo
Comment

Wild-type MIC distributions must be considered to set clinically meaningful susceptibility testing breakpoints for all bacterial pathogens, including Mycobacterium tuberculosis

Kristian Angeby et al. Antimicrob Agents Chemother. 2011 Sep.
No abstract available

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Figures

Fig. 1.
Fig. 1.
Wild-type MIC distributions of rifampin and isoniazid compared to current and suggested susceptibility testing breakpoints. Reproduced with permission from Oxford University Press (6). Wild-type MIC distributions were obtained on Middlebrook 7H10 medium using a replicator and compared to previous Bactec 460 susceptibility results (6). The bars with vertical lines represent the wild-type MIC distributions, and filled bars represent isolates that had previously been categorized as resistant. The current breakpoints and the breakpoints suggested by the authors (5) are indicated with arrows. Clearly, the suggested breakpoints would classify most of the wild-type strains (by definition lacking resistance mechanisms) as resistant and most of the corresponding patients as cases of multidrug-resistant tuberculosis. Also, the suggested breakpoints split the wild-type MIC distribution, which could lead to serious reproducibility problems. (a) Rifampin; (b) isoniazid.
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References

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