7/7/2015 AntimicrobialSusceptibilityTestingofPneumococci:DeterminationofKirbyBauerBreakpointsforPenicillinG,Erythromycin,Clindamycin,Tetracycline

Antimicrobial Agents and Chemotherapy

aac.asm.org

doi: 10.1128/AAC.16.2.190
Antimicrob. Agents Chemother. August 1979 vol. 16 no. 2 190-197

AntimicrobialSusceptibilityTestingofPneumococci:
DeterminationofKirbyBauerBreakpointsfor
PenicillinG,Erythromycin,Clindamycin,Tetracycline,
Chloramphenicol,andRifampin
M. R. Jacobs, Y. Mithal, R. M. Robins-Browne, M. N. Gaspar and H. J. Koornhof
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Author Affiliations

ABSTRACT
Antimicrobial susceptibility testing of pneumococci is now essential to monitor for
the presence of resistance to agents such as the penicillins, macrolides,
lincomycins, chloramphenicol, and tetracycline. In this study, clinical isolates of a
selection of resistant South African strains were tested for antimicrobial
susceptibility by minimal inhibitory concentration (MIC) determination and by a
modified Kirby-Bauer disk diffusion technique, using Mueller-Hinton medium
supplemented with 5% horse blood. Disk diffusion breakpoints were determined
for penicillin G, erythromycin, clindamycin, tetracycline, chloramphenicol, and
rifampin. Reliable results were obtained on disk diffusion for all these agents
except for penicillin G. With 6-g penicillin G disks, zones of strains with
intermediate penicillin susceptibility overlapped those of sensitive and resistant
strains. With 5-g methicillin disks, clearer separation of strains based on
susceptibility to penicillin G occurred. Strains with zones of <35 mm around
penicillin G disks and <25 mm around methicillin disks should have penicillin G
MICs determined to confirm their resistance to penicillin G. In view of the potential
for pneumococci to be resistant to the agents used in this study, antimicrobial
susceptibility of all clinically significant isolates should be determined.

FOOTNOTES
Present address: Institute of Pathology, Case Western Reserve University,
Cleveland, OH 44106.
Copyright 1979, American Society for Microbiology

Articlescitingthisarticle
Determination of Penicillin MICs for Streptococcus pneumoniae by
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J. Clin. Microbiol. January 1998 36:1 179-183
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