Levofloxacin susceptibility testing for Helicobacter pylori in China: comparison of E-test and disk diffusion method

Helicobacter. 2011 Apr;16(2):119-23. doi: 10.1111/j.1523-5378.2011.00820.x.

Abstract

Background: The aims of this study were to compare disk diffusion with E-test method for levofloxacin susceptibility testing of Helicobacter pylori and standardized breakpoints for disk diffusion as a stable and reliable method for determining qualitative levofloxacin susceptibility.

Materials and methods: We determined the levofloxacin susceptibility of 45 H. pylori strains isolated from Chinese patients by the E-test method. Disk diffusion was evaluated as an alternative method to determine susceptibility and compared with the E-test results by linear regression analysis.

Results: The minimum inhibitory concentration (MIC) values tested by E-test method ranged from 0.047 to 32 μg/mL. Resistance to levofloxacin was detected in 16 (35.6%) isolates. The levofloxacin disk zone sizes obtained by disk diffusion method correlated well (r² = .877) with the MICs obtained by E-test method. As a consequence of regression analysis, isolates with inhibition diameters < 12 mm were considered resistant to levofloxacin. There was 100% agreement between the two methods for levofloxacin, applying the regression-based breakpoints.

Conclusions: The disk diffusion method is equivalent to the E-test method for testing levofloxacin susceptibility of H. pylori strains; it is more practical and inexpensive, and it is suitable for the analysis of a small number of isolates compared with the E-test method.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacology*
  • Female
  • Helicobacter pylori / drug effects*
  • Humans
  • Levofloxacin*
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Ofloxacin / pharmacology*

Substances

  • Anti-Bacterial Agents
  • Levofloxacin
  • Ofloxacin