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Antibiotic sensitivity testing

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Antibiotic sensitivity testing or antibiotic susceptibility testing is the measurement of the <a href="https://en.wiktionary.org/wiki/susceptible#Adjective" class="extiw external" title="wikt:susceptible">susceptibility</a> of <a href="Bacteria" title="Bacteria">bacteria</a> to <a href="Antibiotic" title="Antibiotic">antibiotics</a>. It is used because bacteria may have <a href="Antimicrobial_resistance" title="Antimicrobial resistance">resistance</a> to some antibiotics. Sensitivity testing results can allow a clinician to change the choice of antibiotics from <a href="Empiric_therapy" title="Empiric therapy">empiric therapy</a>, which is when an antibiotic is selected based on clinical suspicion about the site of an infection and common causative bacteria, to <a href="Directed_therapy" title="Directed therapy">directed therapy</a>, in which the choice of antibiotic is based on knowledge of the organism and its sensitivities.<a href="#cite_note-Leekha2011-1">[1]</a>

Sensitivity testing usually occurs in a <a href="Medical_laboratory" title="Medical laboratory">medical laboratory</a>, and uses <a href="Microbial_culture" class="mw-redirect" title="Microbial culture">culture</a> methods that expose bacteria to antibiotics, or genetic methods that test to see if bacteria have genes that confer resistance. Culture methods often involve measuring the diameter of areas without bacterial growth, called zones of inhibition, around paper discs containing antibiotics on <a href="Agar_plate" title="Agar plate">agar culture dishes</a> that have been evenly inoculated with bacteria. The <a href="Minimum_inhibitory_concentration" title="Minimum inhibitory concentration">minimum inhibitory concentration</a>, which is the lowest concentration of the antibiotic that stops the growth of bacteria, can be estimated from the size of the zone of inhibition.

Antibiotic susceptibility testing has been needed since the discovery of the <a href="Beta-lactam" class="mw-redirect" title="Beta-lactam">beta-lactam</a> antibiotic <a href="Penicillin" title="Penicillin">penicillin</a>. Initial methods were phenotypic, and involved culture or dilution. The <a href="Etest" title="Etest">Etest</a>, an antibiotic impregnated strip, has been available since the 1980s, and genetic methods such as <a href="Polymerase_chain_reaction" title="Polymerase chain reaction">polymerase chain reaction</a> (PCR) testing have been available since the early 2000s. Research is ongoing into improving current methods by making them faster or more accurate, as well as developing new methods for testing, such as <a href="Microfluidics" title="Microfluidics">microfluidics</a>.

In clinical medicine, antibiotics are most frequently prescribed on the basis of a person's <a href="Symptom" class="mw-redirect" title="Symptom">symptoms</a> and <a href="Medical_guideline" title="Medical guideline">medical guidelines</a>. This method of antibiotic selection is called <a href="Empiric_therapy" title="Empiric therapy">empiric therapy</a>,<a href="#cite_note-Leekha2011-1">[1]</a> and it is based on knowledge about what bacteria cause an infection, and to what antibiotics bacteria may be sensitive or resistant.<a href="#cite_note-Leekha2011-1">[1]</a> For example, a simple <a href="Urinary_tract_infection" title="Urinary tract infection">urinary tract infection</a> might be treated with <a href="Trimethoprim/sulfamethoxazole" title="Trimethoprim/sulfamethoxazole">trimethoprim/sulfamethoxazole</a>.<a href="#cite_note-IDSA2011-2">[2]</a> This is because <a href="Escherichia_coli" title="Escherichia coli">Escherichia coli</a> is the most likely causative bacterium, and may be sensitive to that <a href="Combination_antibiotic" title="Combination antibiotic">combination antibiotic</a>.<a href="#cite_note-IDSA2011-2">[2]</a> However, bacteria can be resistant to several classes of <a href="Antibiotics" class="mw-redirect" title="Antibiotics">antibiotics</a>.<a href="#cite_note-IDSA2011-2">[2]</a> This resistance might be because a type of bacteria has intrinsic resistance to some antibiotics,<a href="#cite_note-IDSA2011-2">[2]</a> because of resistance following past exposure to antibiotics,<a href="#cite_note-IDSA2011-2">[2]</a> or because resistance may be transmitted from other sources such as <a href="Plasmid" title="Plasmid">plasmids</a>.<a href="#cite_note-pmid30068738-3">[3]</a> Antibiotic sensitivity testing provides information about which antibiotics are more likely to be successful and should therefore be used to treat the infection.<a href="#cite_note-Leekha2011-1">[1]</a>

Antibiotic sensitivity testing is also conducted at a population level in some countries as a form of <a href="Screening_(medicine)" title="Screening (medicine)">screening</a>.<a href="#cite_note-:0-4">[4]</a> This is to assess the background rates of resistance to antibiotics (for example with <a href="Methicillin-resistant_Staphylococcus_aureus" title="Methicillin-resistant Staphylococcus aureus">methicillin-resistant Staphylococcus aureus</a>), and may influence guidelines and <a href="Public_health" title="Public health">public health</a> measures.<a href="#cite_note-:0-4">[4]</a>

<div class="mw-heading mw-heading2"><h2 id="Methods">Methods</h2></div>

Once a bacterium has been identified following <a href="Microbiological_culture" title="Microbiological culture">microbiological culture</a>, antibiotics are selected for susceptibility testing.<a href="#cite_note-Reller2009-5">[5]</a> Susceptibility testing methods are based on exposing bacteria to antibiotics and observing the effect on the growth of the bacteria (phenotypic testing), or identifying specific genetic markers (<a href="Genetic_testing" title="Genetic testing">genetic testing</a>).<a href="#cite_note-:6-6">[6]</a> Methods used may be qualitative, meaning that a result indicates resistance is or is not present; or quantitative, using a <a href="Minimum_inhibitory_concentration" title="Minimum inhibitory concentration">minimum inhibitory concentration</a> (MIC) to describe the concentration of antibiotic to which a bacterium is sensitive.<a href="#cite_note-:6-6">[6]</a>

There are many factors that can affect the results of antibiotic sensitivity testing, including failure of the instrument, temperature, moisture, and potency of the antimicrobial agent. <a href="Analytical_quality_control" title="Analytical quality control">Quality control</a> (QC) testing helps to ensure the accuracy of test results.<a href="#cite_note-FOOTNOTEMahon201895-7">[7]</a> Organizations such as the <a href="American_Type_Culture_Collection" class="mw-redirect" title="American Type Culture Collection">American Type Culture Collection</a> and <a href="National_Collection_of_Type_Cultures" title="National Collection of Type Cultures">National Collection of Type Cultures</a> provide strains of bacteria with known resistance phenotypes that can be used for quality control.<a href="#cite_note-FOOTNOTEFord201970-8">[8]</a>

<div class="mw-heading mw-heading3"><h3 id="Phenotypic_methods">Phenotypic methods</h3></div>

Testing based on exposing bacteria to antibiotics uses <a href="Agar_plate" title="Agar plate">agar plates</a> or dilution in agar or broth.<a href="#cite_note-Pulido2013-9">[9]</a> The selection of antibiotics will depend on the organism grown, and the antibiotics that are available locally.<a href="#cite_note-Reller2009-5">[5]</a> To ensure that the results are accurate, the concentration of bacteria that is added to the agar or broth (the <a href="https://en.wiktionary.org/wiki/inoculum" class="extiw external" title="wikt:inoculum">inoculum</a>) must be standardized. This is accomplished by comparing the <a href="Turbidity" title="Turbidity">turbidity</a> of bacteria suspended in saline or broth to <a href="McFarland_standards" title="McFarland standards">McFarland standards</a>—solutions whose turbidity is equivalent to that of a suspension containing a given concentration of bacteria. Once an appropriate concentration (most commonly an 0.5 McFarland standard)<a href="#cite_note-FOOTNOTEMahon2018273-10">[10]</a> has been reached, which can be determined by visual inspection or by <a href="Photometry_(optics)" title="Photometry (optics)">photometry</a>, the inoculum is added to the <a href="Growth_medium" title="Growth medium">growth medium</a>.<a href="#cite_note-:2-11">[11]</a><a href="#cite_note-FOOTNOTEMahon2018273-10">[10]</a>

<div class="mw-heading mw-heading4"><h4 id="Manual">Manual</h4></div>

The <a href="Disk_diffusion_test" title="Disk diffusion test">disc diffusion</a> method involves selecting a strain of bacteria, placing it on an agar plate, and observing bacterial growth near antibiotic-impregnated discs.<a href="#cite_note-12">[12]</a> This is also called the <a href="Kirby-Bauer_antibiotic_testing" class="mw-redirect" title="Kirby-Bauer antibiotic testing">Kirby-Bauer method</a>,<a href="#cite_note-13">[13]</a> although modified methods are also used.<a href="#cite_note-Jorgensen2015-14">[14]</a> In some cases, <a href="Urine_sample" class="mw-redirect" title="Urine sample">urine samples</a> or positive <a href="Blood_culture" title="Blood culture">blood culture</a> samples are applied directly to the test medium, bypassing the preliminary step of isolating the organism.<a href="#cite_note-FOOTNOTEFord201961-15">[15]</a> If the antibiotic inhibits microbial growth, a clear ring, or zone of inhibition, is seen around the disc. The bacteria are classified as sensitive, intermediate, or resistant to an antibiotic by comparing the diameter of the zone of inhibition to defined thresholds which correlate with MICs.<a href="#cite_note-Jorgensen2015-14">[14]</a><a href="#cite_note-FOOTNOTEMahon2018278–9-16">[16]</a>

<a href="Mueller%E2%80%93Hinton_agar" title="Mueller–Hinton agar">Mueller–Hinton agar</a> is frequently used in the disc diffusion test.<a href="#cite_note-Jorgensen2015-14">[14]</a> The <a href="Clinical_and_Laboratory_Standards_Institute" title="Clinical and Laboratory Standards Institute">Clinical and Laboratory Standards Institute</a> (CLSI) and <a href="European_Committee_on_Antimicrobial_Susceptibility_Testing" title="European Committee on Antimicrobial Susceptibility Testing">European Committee on Antimicrobial Susceptibility Testing</a> (EUCAST) provide standards for the type and depth of agar, temperature of incubation, and method of analysing results.<a href="#cite_note-:2-11">[11]</a> Disc diffusion is considered the cheapest and most simple of the methods used to test for susceptibility, and is easily adapted to testing newly available antibiotics or formulations.<a href="#cite_note-Reller2009-5">[5]</a> Some slow-growing and fastidious bacteria cannot be accurately tested by this method,<a href="#cite_note-Reller2009-5">[5]</a> while others, such as Streptococcus species and <a href="Haemophilus_influenzae" title="Haemophilus influenzae">Haemophilus influenzae</a>, can be tested but require specialized growth media and incubation conditions.<a href="#cite_note-FOOTNOTEMahon2018279–82-17">[17]</a>

Gradient methods, such as <a href="Etest" title="Etest">Etest</a>, use a plastic strip placed on agar.<a href="#cite_note-Reller2009-5">[5]</a> A plastic strip impregnated with different concentrations of antibiotics is placed on a growth medium, and the growth medium is viewed after a period of incubation.<a href="#cite_note-Reller2009-5">[5]</a> The minimum inhibitory concentration can be identified based on the intersection of the teardrop-shaped zone of inhibition with the marking on the strip.<a href="#cite_note-Reller2009-5">[5]</a> Multiple strips for different antibiotics may be used.<a href="#cite_note-Reller2009-5">[5]</a> This type of test is considered a diffusion test.<a href="#cite_note-FOOTNOTEBurnett2005169-18">[18]</a>

In agar and broth dilution methods, bacteria are placed in multiple small tubes with different concentrations of antibiotics.<a href="#cite_note-Jorgensen2015-14">[14]</a> Whether a bacterium is sensitive or not is determined by visual inspection or automatic optical methods, after a period of incubation.<a href="#cite_note-Reller2009-5">[5]</a> Broth dilution is considered the gold standard for phenotypic testing.<a href="#cite_note-Jorgensen2015-14">[14]</a> The lowest concentration of antibiotics that inhibits growth is considered the MIC.<a href="#cite_note-Reller2009-5">[5]</a>

<div class="mw-heading mw-heading4"><h4 id="Automated">Automated</h4></div>

Automated systems exist that replicate manual processes, for example, by using imaging and software analysis to report the zone of inhibition in diffusion testing, or dispensing samples and determining results in dilutional testing.<a href="#cite_note-Jorgensen2015-14">[14]</a> Automated instruments, such as the VITEK 2, BD Phoenix, and Microscan systems, are the most common methodology for AST. The specifications of each instrument vary, but the basic principle involves the introduction of a bacterial suspension into pre-formulated panels of antibiotics. The panels are incubated and the inhibition of bacterial growth by the antibiotic is automatically measured using methodologies such as <a href="Turbidimetry" title="Turbidimetry">turbidimetry</a>, <a href="Spectrophotometry" title="Spectrophotometry">spectrophotometry</a> or <a href="Fluorescence" title="Fluorescence">fluorescence</a> detection.<a href="#cite_note-FOOTNOTEMcPherson20171157-19">[19]</a> An <a href="Expert_system" title="Expert system">expert system</a> correlates the MICs with susceptibility results,<a href="#cite_note-pmid21734247-20">[20]</a> and the results are automatically transmitted into the <a href="Laboratory_information_system" class="mw-redirect" title="Laboratory information system">laboratory information system</a> for validation and reporting. While such automated testing is less labour-intensive and more standardized than manual testing, its accuracy can be comparatively poor for certain organisms and antibiotics,<a href="#cite_note-FOOTNOTEMcPherson20171157–8-21">[21]</a> so the disc diffusion test remains useful as a backup method.<a href="#cite_note-FOOTNOTEFord201964-22">[22]</a>

<div class="gallerytext">Multitarget microbial panel for automatic sensitivity testing. A small amount of the bacteria to be tested is placed in each well, each of which has the ingredients for a separate test.</div>

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<div class="gallerytext">Microbial panels loaded into an instrument used for automated antibiotic sensitivity testing of each well</div>

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<div class="gallerytext">A laboratory worker reviews sensitivity results displayed on the screen of the automated analyzer.</div>

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<div class="mw-heading mw-heading3"><h3 id="Genetic_methods">Genetic methods</h3></div>

Genetic testing, such as via <a href="Polymerase_chain_reaction" title="Polymerase chain reaction">polymerase chain reaction</a> (PCR), <a href="DNA_microarray" title="DNA microarray">DNA microarray</a>, and <a href="Loop-mediated_isothermal_amplification" title="Loop-mediated isothermal amplification">loop-mediated isothermal amplification</a>, may be used to detect whether bacteria possess genes which confer antibiotic resistance.<a href="#cite_note-Pulido2013-9">[9]</a><a href="#cite_note-pmid28275006-23">[23]</a> An example is the use of PCR to detect the <a href="MecA" title="MecA">mecA</a> gene for <a href="Beta-lactam" class="mw-redirect" title="Beta-lactam">beta-lactam</a> resistant <a href="Staphylococcus_aureus" title="Staphylococcus aureus">Staphylococcus aureus</a>.<a href="#cite_note-Pulido2013-9">[9]</a> Other examples include assays for testing <a href="Vancomycin" title="Vancomycin">vancomycin</a> resistance genes vanA and vanB in <a href="Enterococcus" title="Enterococcus">Enterococcus</a> species, and antibiotic resistance in <a href="Pseudomonas_aeruginosa" title="Pseudomonas aeruginosa">Pseudomonas aeruginosa</a>, <a href="Klebsiella_pneumoniae" title="Klebsiella pneumoniae">Klebsiella pneumoniae</a> and Escherichia coli.<a href="#cite_note-Pulido2013-9">[9]</a> These tests have the benefit of being direct and rapid, as compared with observable methods,<a href="#cite_note-Pulido2013-9">[9]</a> and have a high likelihood of detecting a finding when there is one to detect.<a href="#cite_note-Arena2015-24">[24]</a> However, whether resistance genes are detected does not always match the resistance profile seen with phenotypic method.<a href="#cite_note-Pulido2013-9">[9]</a> The tests are also expensive and require specifically trained personnel.<a href="#cite_note-Khan2019-25">[25]</a>

Polymerase chain reaction is a method of identifying genes related to antibiotic susceptibility.<a href="#cite_note-:1-26">[26]</a> In the PCR process, a bacterium's DNA is denatured and the two strands of the double helix separate. <a href="DNA_primer" class="mw-redirect" title="DNA primer">Primers</a> specific to a sought-after gene are added to a solution containing the DNA, and a <a href="DNA_polymerase" title="DNA polymerase">DNA polymerase</a> is added alongside a mixture containing molecules that will be needed (for example, <a href="Nucleotide" title="Nucleotide">nucleotides</a> and <a href="Ion" title="Ion">ions</a>).<a href="#cite_note-Khan2019-25">[25]</a> If the relevant gene is present, every time this process runs, the quantity of the target gene will be doubled.<a href="#cite_note-Khan2019-25">[25]</a> After this process, the presence of the genes is demonstrated through a variety of methods including <a href="Electrophoresis" title="Electrophoresis">electrophoresis</a>, <a href="Southern_blot" title="Southern blot">southern blotting</a>, and other <a href="DNA_sequencing" title="DNA sequencing">DNA sequencing</a> analysis methods.<a href="#cite_note-Khan2019-25">[25]</a>

DNA microarrays and chips use the binding of <a href="Complementary_DNA" title="Complementary DNA">complementary DNA</a> to a target gene or nucleic acid sequence.<a href="#cite_note-Pulido2013-9">[9]</a> The benefit of this is that multiple genes can be assessed simultaneously.<a href="#cite_note-Pulido2013-9">[9]</a>

Using magnetic nanoparticles studded with a beta-2-glycoprotein I peptide imitating a plasma protein, microbial pathogens could selectively be retrieved from blood culture specimens within hours, in a study published September 2024. Magnets are used to fish out the peptide-bacterial complex, followed by genetic testing.<a href="#cite_note-27">[27]</a>

<div class="mw-heading mw-heading3"><h3 id="MALDI-TOF">MALDI-TOF</h3></div>

<a href="Matrix-assisted_laser_desorption/ionization" title="Matrix-assisted laser desorption/ionization">Matrix-assisted laser desorption ionisation-time of flight mass spectrometry (MALDI-TOF MS)</a> is another method of susceptibility testing.<a href="#cite_note-:6-6">[6]</a> This is a form of <a href="Time-of-flight_mass_spectrometry" title="Time-of-flight mass spectrometry">time-of-flight mass spectrometry</a>, in which the molecules of a bacterium are subject to <a href="Matrix-assisted_laser_desorption/ionization" title="Matrix-assisted laser desorption/ionization">matrix-assisted laser desorption</a>.<a href="#cite_note-:1-26">[26]</a> The ionised particles are then accelerated, and spectral peaks recorded, producing an expression profile, which is capable of differentiating specific bacterial strains after being compared to known profiles.<a href="#cite_note-:1-26">[26]</a> This includes, in the context of antibiotic susceptibility testing, strains such as <a href="Beta-lactamase" title="Beta-lactamase">beta-lactamase</a> producing <a href="E._coli" class="mw-redirect" title="E. coli">E. coli</a>.<a href="#cite_note-Pulido2013-9">[9]</a> MALDI-TOF is rapid and automated.<a href="#cite_note-Pulido2013-9">[9]</a> There are limitations to testing in this format however; results may not match the results of phenotypic testing,<a href="#cite_note-Pulido2013-9">[9]</a> and acquisition and maintenance is expensive.<a href="#cite_note-Khan2019-25">[25]</a>

<div class="mw-heading mw-heading2"><h2 id="Reporting">Reporting</h2></div>

Bacteria are marked as sensitive, resistant, or having intermediate resistance to an antibiotic based on the minimum inhibitory concentration (MIC), which is the lowest concentration of the antibiotic that stops the growth of bacteria. The MIC is compared to standard threshold values (called "breakpoints") for a given bacterium and antibiotic.<a href="#cite_note-Guiliano2019-28">[28]</a> Breakpoints for the same organism and antibiotic may differ based on the site of infection:<a href="#cite_note-FOOTNOTEMcPherson20171154-29">[29]</a> for example, the CLSI generally defines <a href="Streptococcus_pneumoniae" title="Streptococcus pneumoniae">Streptococcus pneumoniae</a> as sensitive to <a href="Intravenous" class="mw-redirect" title="Intravenous">intravenous</a> penicillin if MICs are ≤0.06 μg/ml, intermediate if MICs are 0.12 to 1 μg/ml, and resistant if MICs are ≥2 μg/ml, but for cases of <a href="Meningitis" title="Meningitis">meningitis</a>, the breakpoints are considerably lower.<a href="#cite_note-30">[30]</a> Sometimes, whether an antibiotic is marked as resistant is also based on bacterial characteristics that are associated with known methods of resistance such as the potential for <a href="Beta_lactamase" class="mw-redirect" title="Beta lactamase">beta-lactamase</a> production.<a href="#cite_note-Guiliano2019-28">[28]</a><a href="#cite_note-pmid21734247-20">[20]</a> Specific patterns of drug resistance or <a href="Multiple_drug_resistance" title="Multiple drug resistance">multidrug resistance</a> may be noted, such as the presence of an <a href="Extended-spectrum_beta-lactamase" class="mw-redirect" title="Extended-spectrum beta-lactamase">extended-spectrum beta lactamase</a>.<a href="#cite_note-Guiliano2019-28">[28]</a> Such information may be useful to the clinician, who can change the empiric treatment to a tailored treatment that is directed only at the causative bacterium.<a href="#cite_note-Leekha2011-1">[1]</a><a href="#cite_note-Pulido2013-9">[9]</a> The results of antimicrobial susceptibility tests performed during a given time period can be compiled, usually in the form of a table, to form an antibiogram.<a href="#cite_note-31">[31]</a><a href="#cite_note-:3-32">[32]</a> Antibiograms help the clinician to select the best empiric antimicrobial therapy based on the local resistance patterns until the laboratory test results are available.<a href="#cite_note-:3-32">[32]</a>

<div class="mw-heading mw-heading2"><h2 id="Clinical_practice">Clinical practice</h2></div>

Ideal antibiotic therapy is based on determining the causal agent and its antibiotic sensitivity. Empiric treatment is often started before laboratory microbiological reports are available. This might be for common or relatively minor infections based on clinical guidelines (such as <a href="Community-acquired_pneumonia" title="Community-acquired pneumonia">community-acquired pneumonia</a>), or for serious infections, such as <a href="Sepsis" title="Sepsis">sepsis</a> or <a href="Bacterial_meningitis" class="mw-redirect" title="Bacterial meningitis">bacterial meningitis</a>, in which delayed treatment carries substantial risks.<a href="#cite_note-Leekha2011-1">[1]</a> The effectiveness of individual antibiotics varies with the anatomical site of the infection, the ability of the antibiotic to reach the site of infection, and the ability of the bacteria to resist or inactivate the antibiotic.<a href="#cite_note-FOOTNOTEBurnett2005167-34">[34]</a>

Specimens for antibiotic sensitivity testing are ideally collected before treatment is started.<a href="#cite_note-Leekha2011-1">[1]</a> A sample may be taken from the site of a suspected infection; such as a <a href="Blood_culture" title="Blood culture">blood culture</a> sample when bacteria are suspected to be present in the bloodstream (<a href="Bacteraemia" class="mw-redirect" title="Bacteraemia">bacteraemia</a>), a <a href="Sputum" title="Sputum">sputum</a> sample in the case of a <a href="Pneumonia" title="Pneumonia">pneumonia</a>, or a <a href="Urine" title="Urine">urine</a> sample in the case of a <a href="Urinary_tract_infection" title="Urinary tract infection">urinary tract infection</a>. Sometimes multiple samples may be taken if the source of an infection is not clear.<a href="#cite_note-Leekha2011-1">[1]</a> These samples are transferred to the <a href="Medical_laboratory" title="Medical laboratory">microbiology laboratory</a> where they are added to <a href="Microbiological_culture" title="Microbiological culture">culture media</a>, in or on which the bacteria grow until they are present in sufficient quantities for identification and sensitivity testing to be carried out.<a href="#cite_note-FOOTNOTEBurnett2005135–144-35">[35]</a><a href="#cite_note-Guiliano2019-28">[28]</a>

When antibiotic sensitivity testing is completed, it will report the organisms present in the sample, and which antibiotics they are susceptible to.<a href="#cite_note-Guiliano2019-28">[28]</a> Although antibiotic sensitivity testing is done in a laboratory (<a href="In_vitro" title="In vitro">in vitro</a>), the information provided about this is often clinically relevant to the antibiotics in a person (<a href="In_vivo" title="In vivo">in vivo</a>).<a href="#cite_note-FOOTNOTEBurnett2005168-36">[36]</a> Sometimes, a decision must be made for some bacteria as to whether they are the cause of an infection, or simply <a href="Commensalism" title="Commensalism">commensal</a> bacteria or contaminants,<a href="#cite_note-Guiliano2019-28">[28]</a> such as <a href="Staphylococcus_epidermidis" title="Staphylococcus epidermidis">Staphylococcus epidermidis</a><a href="#cite_note-37">[37]</a> and other <a href="Opportunistic_infection" title="Opportunistic infection">opportunistic infections</a>. Other considerations may influence the choice of antibiotics, including the need to penetrate through to an infected site (such as an <a href="Abscess" title="Abscess">abscess</a>), or the suspicion that one or more causes of an infection were not detected in a sample.<a href="#cite_note-Leekha2011-1">[1]</a>

<div class="mw-heading mw-heading2"><h2 id="History">History</h2></div>

Since the discovery of the <a href="Beta-lactam" class="mw-redirect" title="Beta-lactam">beta-lactam</a> antibiotic <a href="Penicillin" title="Penicillin">penicillin</a>, the rates of antimicrobial resistance have increased.<a href="#cite_note-FOOTNOTEBurnett2005166-38">[38]</a> Over time, methods for testing the sensitivity of bacteria to antibiotics have developed and changed.<a href="#cite_note-Khan2019-25">[25]</a>

<a href="Alexander_Fleming" title="Alexander Fleming">Alexander Fleming</a> in the 1920s developed the first method of susceptibility testing. The "gutter method" that he developed was a diffusion method, involving an antibiotic that was diffused through a gutter made of agar.<a href="#cite_note-Khan2019-25">[25]</a> In the 1940s, multiple investigators, including Pope, Foster and Woodruff, Vincent and Vincent used paper discs instead.<a href="#cite_note-Khan2019-25">[25]</a> All these methods involve testing only susceptibility to penicillin.<a href="#cite_note-Khan2019-25">[25]</a> The results were difficult to interpret and not reliable, because of inaccurate results that were not standardised between laboratories.<a href="#cite_note-Khan2019-25">[25]</a>

Dilution has been used as a method to grow and identify bacteria since the 1870s, and as a method of testing the susceptibility of bacteria to antibiotics since 1929, also by Alexander Fleming.<a href="#cite_note-Khan2019-25">[25]</a> The way of determining susceptibility changed from how turbid the solution was, to the pH (in 1942), to optical instruments.<a href="#cite_note-Khan2019-25">[25]</a> The use of larger tube-based "macrodilution" testing has been superseded by smaller "microdilution" kits.<a href="#cite_note-Reller2009-5">[5]</a>

In 1966, the <a href="World_Health_Organization" title="World Health Organization">World Health Organisation</a> confirmed the <a href="Disk_diffusion_test" title="Disk diffusion test">Kirby–Bauer method</a> as the standard method for susceptibility testing; it is simple, cost-effective and can test multiple antibiotics.<a href="#cite_note-Khan2019-25">[25]</a>

The Etest was developed in 1980 by Bolmstrӧm and Eriksson, and MALDI-TOF developed in 2000s.<a href="#cite_note-Khan2019-25">[25]</a> An array of automated systems has been developed since and after the 1980s.<a href="#cite_note-Khan2019-25">[25]</a> PCR was the first genetic test available and first published as a method of detecting antibiotic susceptibility in 2001.<a href="#cite_note-Khan2019-25">[25]</a>

<div class="mw-heading mw-heading2"><h2 id="Further_research">Further research</h2></div>

<a href="Point-of-care_testing" title="Point-of-care testing">Point-of-care testing</a> is being developed to speed up the time for testing, and to help practitioners avoid prescribing unnecessary antibiotics in the style of <a href="Precision_medicine" class="mw-redirect" title="Precision medicine">precision medicine</a>.<a href="#cite_note-39">[39]</a> Traditional techniques typically take between 12 and 48 hours,<a href="#cite_note-:6-6">[6]</a> although it can take up to five days.<a href="#cite_note-Guiliano2019-28">[28]</a> In contrast, rapid testing using <a href="Molecular_diagnostics" title="Molecular diagnostics">molecular diagnostics</a> is defined as "being feasible within an 8-h(our) working shift".<a href="#cite_note-:6-6">[6]</a> Progress has been slow due to a range of reasons including cost and regulation.<a href="#cite_note-40">[40]</a>

Additional research is focused at the shortcomings of current testing methods. As well as the duration it takes to report phenotypic methods, they are laborious, have difficult portability and are difficult to use in resource-limited settings, and have a chance of cross-contamination.<a href="#cite_note-Khan2019-25">[25]</a>

As of 2017, point-of-care resistance diagnostics were available for <a href="Methicillin-resistant_Staphylococcus_aureus" title="Methicillin-resistant Staphylococcus aureus">methicillin-resistant Staphylococcus aureus</a> (MRSA), <a href="Rifampin" class="mw-redirect" title="Rifampin">rifampin</a>-resistant <a href="Mycobacterium_tuberculosis" title="Mycobacterium tuberculosis">Mycobacterium tuberculosis</a> (TB), and <a href="Vancomycin-resistant_enterococci" class="mw-redirect" title="Vancomycin-resistant enterococci">vancomycin-resistant enterococci</a> (VRE) through <a href="GeneXpert_MTB/RIF" title="GeneXpert MTB/RIF">GeneXpert</a> by molecular diagnostics company <a href="Cepheid_Inc" class="mw-redirect" title="Cepheid Inc">Cepheid</a>.<a href="#cite_note-:5-41">[41]</a>

In 2014 the <a href="Longitude_Prize" title="Longitude Prize">Longitude Prize</a> offered an £8 million payout to the team of researchers that develops an affordable, accurate, and fast <a href="Point-of-care_testing" title="Point-of-care testing">point of care test</a> for <a href="Bacterial_infection" class="mw-redirect" title="Bacterial infection">bacterial infection</a> that is easy to use anywhere in the world. The prize was awarded in 2024 to Sysmex Astrego AB for a 45min <a href="Point-of-care_testing" title="Point-of-care testing">point-of-care</a> antibiotic susceptibility test for <a href="Urinary_tract_infection" title="Urinary tract infection">UTI</a> based on single cell imaging.<a href="#cite_note-42">[42]</a>

Quantitative PCR, with the view of determining the percent of a detected bacteria that possesses a resistance gene, is being explored.<a href="#cite_note-Pulido2013-9">[9]</a> <a href="Whole_genome_sequencing" title="Whole genome sequencing">Whole genome sequencing</a> of isolated bacteria is also being explored, and likely to become more available as costs decrease and speed increases over time.<a href="#cite_note-Pulido2013-9">[9]</a>

Additional methods explored include <a href="Microfluidics" title="Microfluidics">microfluidics</a>, which uses a small amount of fluid and a variety of testing methods, such as optical, electrochemical, and magnetic.<a href="#cite_note-Pulido2013-9">[9]</a> Such assays do not require much fluid to be tested, are rapid and portable.<a href="#cite_note-Pulido2013-9">[9]</a>

The use of fluorescent dyes has been explored.<a href="#cite_note-Pulido2013-9">[9]</a> These involve labelled proteins targeted at <a href="Biomarker" title="Biomarker">biomarkers</a>, nucleic acid sequences present within cells that are found when the bacterium is resistant to an antibiotic.<a href="#cite_note-Pulido2013-9">[9]</a> An isolate of bacteria is fixed in position and then dissolved. The isolate is then exposed to fluorescent dye, which will be luminescent when viewed.<a href="#cite_note-Pulido2013-9">[9]</a>

Improvements to existing platforms are also being explored, including improvements in imaging systems that are able to more rapidly identify the MIC in phenotypic samples; or the use of bioluminescent enzymes that reveal bacterial growth to make changes more easily visible.<a href="#cite_note-Khan2019-25">[25]</a>

<div class="mw-heading mw-heading2"><h2 id="Bibliography">Bibliography</h2></div>

/* start https://en.wikipedia.org/ */

.mw-parser-output .refbegin{margin-bottom:0.5em}.mw-parser-output .refbegin-hanging-indents>ul{margin-left:0}.mw-parser-output .refbegin-hanging-indents>ul>li{margin-left:0;padding-left:3.2em;text-indent:-3.2em}.mw-parser-output .refbegin-hanging-indents ul,.mw-parser-output .refbegin-hanging-indents ul li{list-style:none}@media(max-width:720px){.mw-parser-output .refbegin-hanging-indents>ul>li{padding-left:1.6em;text-indent:-1.6em}}.mw-parser-output .refbegin-columns{margin-top:0.3em}.mw-parser-output .refbegin-columns ul{margin-top:0}.mw-parser-output .refbegin-columns li{page-break-inside:avoid;break-inside:avoid-column}@media screen{.mw-parser-output .refbegin{font-size:90%}}

/* end https://en.wikipedia.org/ */

</style><div class="refbegin" style="">

/* start https://en.wikipedia.org/ */

.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("./mw/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("./mw/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("./mw/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("./mw/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}

/* end https://en.wikipedia.org/ */

</style><cite id="CITEREFBurnett2005" class="citation book cs1">Burnett D (2005). The Science of Laboratory Diagnosis. Chichester, West Sussex, England Hoboken, NJ: Wiley. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>978-0-470-85912-4</bdi>. <a href="OCLC_(identifier)" class="mw-redirect" title="OCLC (identifier)">OCLC</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/oclc/56650888">56650888</a>.</cite></li>

<li><cite id="CITEREFFord2019" class="citation book cs1">Ford, M (5 June 2019). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=_guXDwAAQBAJ&pg=PA90">Medical Microbiology</a>. Oxford University Press. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>978-0-19-881814-4</bdi>.</cite></li>

<li><cite id="CITEREFMahon2018" class="citation book cs1">Mahon C, Lehman D, Manuselis G (2018). Textbook of Diagnostic Microbiology (6 ed.). Elsevier Health Sciences. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>978-0-323-48212-7</bdi>.</cite></li>

<li><cite id="CITEREFMcPherson2017" class="citation book cs1">McPherson, RA; Pincus, MR (2017). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=xAzhCwAAQBAJ">Henry's Clinical Diagnosis and Management by Laboratory Methods</a> (23 ed.). Elsevier Health Sciences. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>978-0-323-41315-2</bdi>.</cite></li></ul>

</div>

<div class="mw-heading mw-heading2"><h2 id="References">References</h2></div>

/* start https://en.wikipedia.org/ */

.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}

/* end https://en.wikipedia.org/ */

</style><div class="reflist">

<li id="cite_note-Leekha2011-1">^ <a href="#cite_ref-Leekha2011_1-0">a</a> <a href="#cite_ref-Leekha2011_1-1">b</a> <a href="#cite_ref-Leekha2011_1-2">c</a> <a href="#cite_ref-Leekha2011_1-3">d</a> <a href="#cite_ref-Leekha2011_1-4">e</a> <a href="#cite_ref-Leekha2011_1-5">f</a> <a href="#cite_ref-Leekha2011_1-6">g</a> <a href="#cite_ref-Leekha2011_1-7">h</a> <a href="#cite_ref-Leekha2011_1-8">i</a> <cite id="CITEREFLeekhaTerrellEdson2011" class="citation journal cs1">Leekha S, Terrell CL, Edson RS (February 2011). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3031442">"General principles of antimicrobial therapy"</a>. Mayo Clinic Proceedings. 86 (2): 156–67. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.4065%2Fmcp.2010.0639">10.4065/mcp.2010.0639</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3031442">3031442</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/21282489">21282489</a>. <q>Once microbiology results have helped to identify the etiologic pathogen and/or antimicrobial susceptibility data are available, every attempt should be made to narrow the antibiotic spectrum. This is a critically important component of antibiotic therapy because it can reduce cost and toxicity and prevent the emergence of antimicrobial resistance in the community</q></cite>

</li>

<li id="cite_note-IDSA2011-2">^ <a href="#cite_ref-IDSA2011_2-0">a</a> <a href="#cite_ref-IDSA2011_2-1">b</a> <a href="#cite_ref-IDSA2011_2-2">c</a> <a href="#cite_ref-IDSA2011_2-3">d</a> <a href="#cite_ref-IDSA2011_2-4">e</a> <cite id="CITEREFKangKimParkKim2018" class="citation journal cs1">Kang CI, Kim J, Park DW, Kim BN, Ha US, Lee SJ, et al. (March 2018). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895837">"Clinical Practice Guidelines for the Antibiotic Treatment of Community-Acquired Urinary Tract Infections"</a>. Infection & Chemotherapy. 50 (1): 67–100. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.3947%2Fic.2018.50.1.67">10.3947/ic.2018.50.1.67</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895837">5895837</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29637759">29637759</a>.</cite>

</li>

<li id="cite_note-pmid30068738-3"><a href="#cite_ref-pmid30068738_3-0">^</a> <cite id="CITEREFPartridgeKwongFirthJensen2018" class="citation journal cs1">Partridge SR, Kwong SM, Firth N, Jensen SO (October 2018). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6148190">"Mobile Genetic Elements Associated with Antimicrobial Resistance"</a>. Clinical Microbiology Reviews. 31 (4). <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1128%2FCMR.00088-17">10.1128/CMR.00088-17</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6148190">6148190</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30068738">30068738</a>.</cite>

</li>

<li id="cite_note-:0-4">^ <a href="#cite_ref-:0_4-0">a</a> <a href="#cite_ref-:0_4-1">b</a> <cite id="CITEREFMoltonTambyahAngLing2013" class="citation journal cs1">Molton JS, Tambyah PA, Ang BS, Ling ML, Fisher DA (May 2013). Weinstein RA (ed.). <a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fcid%2Fcit020">"The global spread of healthcare-associated multidrug-resistant bacteria: a perspective from Asia"</a>. Clinical Infectious Diseases. 56 (9): 1310–8. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fcid%2Fcit020">10.1093/cid/cit020</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23334810">23334810</a>.</cite>

</li>

<li id="cite_note-Reller2009-5">^ <a href="#cite_ref-Reller2009_5-0">a</a> <a href="#cite_ref-Reller2009_5-1">b</a> <a href="#cite_ref-Reller2009_5-2">c</a> <a href="#cite_ref-Reller2009_5-3">d</a> <a href="#cite_ref-Reller2009_5-4">e</a> <a href="#cite_ref-Reller2009_5-5">f</a> <a href="#cite_ref-Reller2009_5-6">g</a> <a href="#cite_ref-Reller2009_5-7">h</a> <a href="#cite_ref-Reller2009_5-8">i</a> <a href="#cite_ref-Reller2009_5-9">j</a> <a href="#cite_ref-Reller2009_5-10">k</a> <cite id="CITEREFJorgensenFerraro2009" class="citation journal cs1">Jorgensen JH, Ferraro MJ (December 2009). <a rel="nofollow" class="external text" href="https://doi.org/10.1086%2F647952">"Antimicrobial susceptibility testing: a review of general principles and contemporary practices"</a>. Clinical Infectious Diseases. 49 (11): 1749–55. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1086%2F647952">10.1086/647952</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/19857164">19857164</a>.</cite>

</li>

<li id="cite_note-:6-6">^ <a href="#cite_ref-:6_6-0">a</a> <a href="#cite_ref-:6_6-1">b</a> <a href="#cite_ref-:6_6-2">c</a> <a href="#cite_ref-:6_6-3">d</a> <a href="#cite_ref-:6_6-4">e</a> <cite id="CITEREFvan_BelkumBachmannLüdkeLisby2019" class="citation journal cs1">van Belkum A, Bachmann TT, Lüdke G, Lisby JG, Kahlmeter G, Mohess A, et al. (January 2019). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7138758">"Developmental roadmap for antimicrobial susceptibility testing systems"</a>. Nature Reviews. Microbiology. 17 (1): 51–62. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fs41579-018-0098-9">10.1038/s41579-018-0098-9</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7138758">7138758</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30333569">30333569</a>.</cite>

</li>

<li id="cite_note-FOOTNOTEMahon201895-7"><a href="#cite_ref-FOOTNOTEMahon201895_7-0">^</a> <a href="#CITEREFMahon2018">Mahon 2018</a>, p. 95.

</li>

<li id="cite_note-FOOTNOTEFord201970-8"><a href="#cite_ref-FOOTNOTEFord201970_8-0">^</a> <a href="#CITEREFFord2019">Ford 2019</a>, p. 70.

</li>

<li id="cite_note-Pulido2013-9">^ <a href="#cite_ref-Pulido2013_9-0">a</a> <a href="#cite_ref-Pulido2013_9-1">b</a> <a href="#cite_ref-Pulido2013_9-2">c</a> <a href="#cite_ref-Pulido2013_9-3">d</a> <a href="#cite_ref-Pulido2013_9-4">e</a> <a href="#cite_ref-Pulido2013_9-5">f</a> <a href="#cite_ref-Pulido2013_9-6">g</a> <a href="#cite_ref-Pulido2013_9-7">h</a> <a href="#cite_ref-Pulido2013_9-8">i</a> <a href="#cite_ref-Pulido2013_9-9">j</a> <a href="#cite_ref-Pulido2013_9-10">k</a> <a href="#cite_ref-Pulido2013_9-11">l</a> <a href="#cite_ref-Pulido2013_9-12">m</a> <a href="#cite_ref-Pulido2013_9-13">n</a> <a href="#cite_ref-Pulido2013_9-14">o</a> <a href="#cite_ref-Pulido2013_9-15">p</a> <a href="#cite_ref-Pulido2013_9-16">q</a> <a href="#cite_ref-Pulido2013_9-17">r</a> <a href="#cite_ref-Pulido2013_9-18">s</a> <cite id="CITEREFPulidoGarcía-QuintanillaMartín-PeñaCisneros2013" class="citation journal cs1">Pulido MR, García-Quintanilla M, Martín-Peña R, Cisneros JM, McConnell MJ (December 2013). <a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fjac%2Fdkt253">"Progress on the development of rapid methods for antimicrobial susceptibility testing"</a>. The Journal of Antimicrobial Chemotherapy. 68 (12): 2710–7. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fjac%2Fdkt253">10.1093/jac/dkt253</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23818283">23818283</a>.</cite>

</li>

<li id="cite_note-FOOTNOTEMahon2018273-10">^ <a href="#cite_ref-FOOTNOTEMahon2018273_10-0">a</a> <a href="#cite_ref-FOOTNOTEMahon2018273_10-1">b</a> <a href="#CITEREFMahon2018">Mahon 2018</a>, p. 273.

</li>

<li id="cite_note-:2-11">^ <a href="#cite_ref-:2_11-0">a</a> <a href="#cite_ref-:2_11-1">b</a> <cite id="CITEREFHombachMaurerPfiffnerBöttger2015" class="citation journal cs1">Hombach, Michael; Maurer, Florian P.; Pfiffner, Tamara; Böttger, Erik C.; Furrer, Reinhard (2015-12-01). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4652116">"Standardization of Operator-Dependent Variables Affecting Precision and Accuracy of the Disk Diffusion Method for Antibiotic Susceptibility Testing"</a>. Journal of Clinical Microbiology. 53 (12): 3864–3869. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1128%2FJCM.02351-15">10.1128/JCM.02351-15</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0095-1137">0095-1137</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4652116">4652116</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26468500">26468500</a>.</cite>

</li>

<li id="cite_note-12"><a href="#cite_ref-12">^</a> <cite id="CITEREFSyalMoYuIriya2017" class="citation journal cs1">Syal K, Mo M, Yu H, Iriya R, Jing W, Guodong S, et al. (2017). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5479269">"Current and emerging techniques for antibiotic susceptibility tests"</a>. Theranostics. 7 (7): 1795–1805. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.7150%2Fthno.19217">10.7150/thno.19217</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5479269">5479269</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28638468">28638468</a>.</cite>

</li>

<li id="cite_note-13"><a href="#cite_ref-13">^</a> <cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20141019173222/http://www.who.int/drugresistance/Antimicrobial_Detection/en/">"WHO | World Health Organization"</a>. WHO. Archived from <a rel="nofollow" class="external text" href="https://www.who.int/drugresistance/Antimicrobial_Detection/en/">the original</a> on October 19, 2014. Retrieved 2020-09-03. <q>The most common methods utilized are the disk diffusion susceptibility test method (also known as Kirby-Bauer)</q></cite>

</li>

<li id="cite_note-Jorgensen2015-14">^ <a href="#cite_ref-Jorgensen2015_14-0">a</a> <a href="#cite_ref-Jorgensen2015_14-1">b</a> <a href="#cite_ref-Jorgensen2015_14-2">c</a> <a href="#cite_ref-Jorgensen2015_14-3">d</a> <a href="#cite_ref-Jorgensen2015_14-4">e</a> <a href="#cite_ref-Jorgensen2015_14-5">f</a> <cite id="CITEREFJorgensenTurnidge2015" class="citation book cs1">Jorgensen, James H.; Turnidge, John D. (2015). "71. Susceptibility Test Methods: Dilution and Disk Diffusion Methods". In Jorgensen, James H; Carroll, Karen C; Funke, Guido; Pfaller, Michael A; Landry, Marie Louise; Richter, Sandra S; Warnock, David W (eds.). Manual of Clinical Microbiology (11th ed.). pp. 1253–1273. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1128%2F9781555817381">10.1128/9781555817381</a>. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>9781683672807</bdi>.</cite>

</li>

<li id="cite_note-FOOTNOTEFord201961-15"><a href="#cite_ref-FOOTNOTEFord201961_15-0">^</a> <a href="#CITEREFFord2019">Ford 2019</a>, p. 61.

</li>

<li id="cite_note-FOOTNOTEMahon2018278–9-16"><a href="#cite_ref-FOOTNOTEMahon2018278–9_16-0">^</a> <a href="#CITEREFMahon2018">Mahon 2018</a>, pp. 278–9.

</li>

<li id="cite_note-FOOTNOTEMahon2018279–82-17"><a href="#cite_ref-FOOTNOTEMahon2018279–82_17-0">^</a> <a href="#CITEREFMahon2018">Mahon 2018</a>, pp. 279–82.

</li>

<li id="cite_note-FOOTNOTEBurnett2005169-18"><a href="#cite_ref-FOOTNOTEBurnett2005169_18-0">^</a> <a href="#CITEREFBurnett2005">Burnett 2005</a>, p. 169.

</li>

<li id="cite_note-FOOTNOTEMcPherson20171157-19"><a href="#cite_ref-FOOTNOTEMcPherson20171157_19-0">^</a> <a href="#CITEREFMcPherson2017">McPherson 2017</a>, p. 1157.

</li>

<li id="cite_note-pmid21734247-20">^ <a href="#cite_ref-pmid21734247_20-0">a</a> <a href="#cite_ref-pmid21734247_20-1">b</a> <cite id="CITEREFWinstanleyCourvalin2011" class="citation journal cs1">Winstanley T, Courvalin P (July 2011). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3131062">"Expert systems in clinical microbiology"</a>. Clinical Microbiology Reviews. 24 (3): 515–56. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1128%2FCMR.00061-10">10.1128/CMR.00061-10</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3131062">3131062</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/21734247">21734247</a>.</cite>

</li>

<li id="cite_note-FOOTNOTEMcPherson20171157–8-21"><a href="#cite_ref-FOOTNOTEMcPherson20171157–8_21-0">^</a> <a href="#CITEREFMcPherson2017">McPherson 2017</a>, pp. 1157–8.

</li>

<li id="cite_note-FOOTNOTEFord201964-22"><a href="#cite_ref-FOOTNOTEFord201964_22-0">^</a> <a href="#CITEREFFord2019">Ford 2019</a>, p. 64.

</li>

<li id="cite_note-pmid28275006-23"><a href="#cite_ref-pmid28275006_23-0">^</a> <cite id="CITEREFPoirelJayolNordmann2017" class="citation journal cs1">Poirel L, Jayol A, Nordmann P (April 2017). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5355641">"Polymyxins: Antibacterial Activity, Susceptibility Testing, and Resistance Mechanisms Encoded by Plasmids or Chromosomes"</a>. Clinical Microbiology Reviews. 30 (2): 557–596. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1128%2FCMR.00064-16">10.1128/CMR.00064-16</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5355641">5355641</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28275006">28275006</a>.</cite>

</li>

<li id="cite_note-Arena2015-24"><a href="#cite_ref-Arena2015_24-0">^</a> <cite id="CITEREFArenaViaggiGalliRossolini2015" class="citation journal cs1">Arena, Fabio; Viaggi, Bruno; Galli, Luisa; Rossolini, Gian Maria (October 2015). <a rel="nofollow" class="external text" href="https://doi.org/10.1097%2FINF.0000000000000844">"Antibiotic Susceptibility Testing: Present and Future"</a>. The Pediatric Infectious Disease Journal. 34 (10): 1128–1130. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2FINF.0000000000000844">10.1097/INF.0000000000000844</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26186102">26186102</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:7058394">7058394</a>.</cite>

</li>

<li id="cite_note-Khan2019-25">^ <a href="#cite_ref-Khan2019_25-0">a</a> <a href="#cite_ref-Khan2019_25-1">b</a> <a href="#cite_ref-Khan2019_25-2">c</a> <a href="#cite_ref-Khan2019_25-3">d</a> <a href="#cite_ref-Khan2019_25-4">e</a> <a href="#cite_ref-Khan2019_25-5">f</a> <a href="#cite_ref-Khan2019_25-6">g</a> <a href="#cite_ref-Khan2019_25-7">h</a> <a href="#cite_ref-Khan2019_25-8">i</a> <a href="#cite_ref-Khan2019_25-9">j</a> <a href="#cite_ref-Khan2019_25-10">k</a> <a href="#cite_ref-Khan2019_25-11">l</a> <a href="#cite_ref-Khan2019_25-12">m</a> <a href="#cite_ref-Khan2019_25-13">n</a> <a href="#cite_ref-Khan2019_25-14">o</a> <a href="#cite_ref-Khan2019_25-15">p</a> <a href="#cite_ref-Khan2019_25-16">q</a> <a href="#cite_ref-Khan2019_25-17">r</a> <cite id="CITEREFKhanSiddiquiPark2019" class="citation journal cs1">Khan ZA, Siddiqui MF, Park S (May 2019). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627445">"Current and Emerging Methods of Antibiotic Susceptibility Testing"</a>. Diagnostics. 9 (2): 49. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.3390%2Fdiagnostics9020049">10.3390/diagnostics9020049</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627445">6627445</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/31058811">31058811</a>.</cite>

</li>

<li id="cite_note-:1-26">^ <a href="#cite_ref-:1_26-0">a</a> <a href="#cite_ref-:1_26-1">b</a> <a href="#cite_ref-:1_26-2">c</a> <cite id="CITEREFBauerPerezForrestGoff2014" class="citation journal cs1 cs1-prop-long-vol">Bauer KA, Perez KK, Forrest GN, Goff DA (October 2014). <a rel="nofollow" class="external text" href="https://academic.oup.com/cid/article/59/suppl_3/S134/318561">"Review of rapid diagnostic tests used by antimicrobial stewardship programs"</a>. Clinical Infectious Diseases. 59 Suppl 3 (suppl_3): S134-45. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fcid%2Fciu547">10.1093/cid/ciu547</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25261540">25261540</a>.</cite>

</li>

<li id="cite_note-27"><a href="#cite_ref-27">^</a> <cite id="CITEREFKimKangJangJoo2024" class="citation journal cs1">Kim, Tae Hyun; Kang, Junwon; Jang, Haewook; Joo, Hyelyn; Lee, Gi Yoon; Kim, Hamin; Cho, Untack; Bang, Hyeeun; Jang, Jisung; Han, Sangkwon; Kim, Dong Young; Lee, Chan Mi; Kang, Chang Kyung; Choe, Pyoeng Gyun; Kim, Nam Joong (August 2024). <a rel="nofollow" class="external text" href="https://www.nature.com/articles/s41586-024-07725-1">"Blood culture-free ultra-rapid antimicrobial susceptibility testing"</a>. Nature. 632 (8026): 893–902. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fs41586-024-07725-1">10.1038/s41586-024-07725-1</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1476-4687">1476-4687</a>.</cite>

</li>

<li id="cite_note-Guiliano2019-28">^ <a href="#cite_ref-Guiliano2019_28-0">a</a> <a href="#cite_ref-Guiliano2019_28-1">b</a> <a href="#cite_ref-Guiliano2019_28-2">c</a> <a href="#cite_ref-Guiliano2019_28-3">d</a> <a href="#cite_ref-Guiliano2019_28-4">e</a> <a href="#cite_ref-Guiliano2019_28-5">f</a> <a href="#cite_ref-Guiliano2019_28-6">g</a> <cite id="CITEREFGiulianoPatelKale-Pradhan2019" class="citation journal cs1">Giuliano C, Patel CR, Kale-Pradhan PB (April 2019). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6428495">"A Guide to Bacterial Culture Identification And Results Interpretation"</a>. P & T. 44 (4): 192–200. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6428495">6428495</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30930604">30930604</a>.</cite>

</li>

<li id="cite_note-FOOTNOTEMcPherson20171154-29"><a href="#cite_ref-FOOTNOTEMcPherson20171154_29-0">^</a> <a href="#CITEREFMcPherson2017">McPherson 2017</a>, p. 1154.

</li>

<li id="cite_note-30"><a href="#cite_ref-30">^</a> <cite id="CITEREFWeinsteinKlugmanJones2009" class="citation journal cs1">Weinstein, Melvin P.; Klugman, Keith P.; Jones, Ronald N. (June 2009). <a rel="nofollow" class="external text" href="https://doi.org/10.1086%2F598975">"Rationale for Revised Penicillin Susceptibility Breakpoints versus Streptococcus pneumoniae: Coping with Antimicrobial Susceptibility in an Era of Resistance"</a>. Clinical Infectious Diseases. 48 (11): 1596–1600. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1086%2F598975">10.1086/598975</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1058-4838">1058-4838</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/19400744">19400744</a>.</cite>

</li>

<li id="cite_note-31"><a href="#cite_ref-31">^</a> <cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.merriam-webster.com/medical/antibiogram">"Medical Definition of ANTIBIOGRAM"</a>. www.merriam-webster.com. Retrieved 2020-07-05.</cite>

</li>

<li id="cite_note-:3-32">^ <a href="#cite_ref-:3_32-0">a</a> <a href="#cite_ref-:3_32-1">b</a> <cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.dhs.wisconsin.gov/antimicrobial-stewardship/antibiogram.htm">"Antimicrobial Stewardship: Antibiogram | Wisconsin Department of Health Services"</a>. www.dhs.wisconsin.gov. 2021-08-09. Retrieved 2023-11-21.</cite>

</li>

<li id="cite_note-33"><a href="#cite_ref-33">^</a> <a rel="nofollow" class="external text" href="http://www.microbelibrary.org/component/resource/laboratory-test/3189-kirby-bauer-disk-diffusion-susceptibility-test-protocol">Kirby-Bauer Disk Diffusion Susceptibility Test Protocol</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20110626190940/http://www.microbelibrary.org/component/resource/laboratory-test/3189-kirby-bauer-disk-diffusion-susceptibility-test-protocol">Archived</a> 26 June 2011 at the <a href="Wayback_Machine" title="Wayback Machine">Wayback Machine</a>, Jan Hudzicki, ASM

</li>

<li id="cite_note-FOOTNOTEBurnett2005167-34"><a href="#cite_ref-FOOTNOTEBurnett2005167_34-0">^</a> <a href="#CITEREFBurnett2005">Burnett 2005</a>, p. 167.

</li>

<li id="cite_note-FOOTNOTEBurnett2005135–144-35"><a href="#cite_ref-FOOTNOTEBurnett2005135–144_35-0">^</a> <a href="#CITEREFBurnett2005">Burnett 2005</a>, pp. 135–144.

</li>

<li id="cite_note-FOOTNOTEBurnett2005168-36"><a href="#cite_ref-FOOTNOTEBurnett2005168_36-0">^</a> <a href="#CITEREFBurnett2005">Burnett 2005</a>, p. 168.

</li>

<li id="cite_note-37"><a href="#cite_ref-37">^</a> <cite id="CITEREFBeckerHeilmannPeters2014" class="citation journal cs1">Becker K, Heilmann C, Peters G (October 2014). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4187637">"Coagulase-negative staphylococci"</a>. Clinical Microbiology Reviews. 27 (4): 870–926. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1128%2FCMR.00109-13">10.1128/CMR.00109-13</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4187637">4187637</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25278577">25278577</a>.</cite>

</li>

<li id="cite_note-FOOTNOTEBurnett2005166-38"><a href="#cite_ref-FOOTNOTEBurnett2005166_38-0">^</a> <a href="#CITEREFBurnett2005">Burnett 2005</a>, p. 166.

</li>

<li id="cite_note-39"><a href="#cite_ref-39">^</a> <cite class="citation news cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20181202202615/https://www.mddionline.com/diagnostics-are-helping-counter-antimicrobial-resistance-more-work-needed">"Diagnostics Are Helping Counter Antimicrobial Resistance, But More Work Is Needed"</a>. MDDI Online. 2018-11-20. Archived from <a rel="nofollow" class="external text" href="https://www.mddionline.com/diagnostics-are-helping-counter-antimicrobial-resistance-more-work-needed">the original</a> on 2018-12-02. Retrieved 2018-12-02.</cite>

</li>

<li id="cite_note-40"><a href="#cite_ref-40">^</a> <cite class="citation journal cs1"><a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fd41586-018-07031-7">"Progress on antibiotic resistance"</a>. Nature. 562 (7727): 307. October 2018. <a href="Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2018Natur.562Q.307.">2018Natur.562Q.307.</a>. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fd41586-018-07031-7">10.1038/d41586-018-07031-7</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30333595">30333595</a>.</cite>

</li>

<li id="cite_note-:5-41"><a href="#cite_ref-:5_41-0">^</a> <cite id="CITEREFMcAdams2017" class="citation journal cs1">McAdams D (January 2017). "Resistance diagnosis and the changing epidemiology of antibiotic resistance". Annals of the New York Academy of Sciences. 1388 (1): 5–17. <a href="Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2017NYASA1388....5M">2017NYASA1388....5M</a>. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fnyas.13300">10.1111/nyas.13300</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28134444">28134444</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:11876363">11876363</a>.</cite>

</li>

<li id="cite_note-42"><a href="#cite_ref-42">^</a> <cite id="CITEREFBaltekin_ÖBoucharinTanoAndersson" class="citation journal cs1">Baltekin Ö, Özden; Boucharin, Alexis; Tano, Eva; Andersson, Dan; Elf, Johan. <a rel="nofollow" class="external text" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC5576829/">"(August 2017). "Antibiotic susceptibility testing in less than 30 min using direct single-cell imaging""</a>. <a href="Proceedings_of_the_National_Academy_of_Sciences_of_the_United_States_of_America" title="Proceedings of the National Academy of Sciences of the United States of America">Proceedings of the National Academy of Sciences of the United States of America</a>. 114 (34): 9170–9175. <a href="Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2017PNAS..114.9170B">2017PNAS..114.9170B</a>. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1073%2Fpnas.1708558114">10.1073/pnas.1708558114</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5576829">5576829</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28790187">28790187</a>.</cite>

</li>

</ol></div></div>

<div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2></div>

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<ul><li><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.health.state.mn.us/diseases/antibioticresistance/abx/antibiograms.pdf">"About Antibiograms (Antimicrobial Susceptibilites of Selected Pathogens)"</a> (PDF). Minnesota Department of Health.</cite></li></ul>

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</style><div id="Use_of_antimicrobials74" style="font-size:114%;margin:0 4em">Use of <a href="Antimicrobial" title="Antimicrobial">antimicrobials</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Types</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Antibacterial" class="mw-redirect" title="Antibacterial">Antibacterial</a></li>

<li><a href="Antifungal" title="Antifungal">Antifungal</a></li>

<li><a href="Antiviral_drug" title="Antiviral drug">Antiviral</a></li>

<li><a href="Antiparasitic" title="Antiparasitic">Antiparasitic</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Concepts</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Antibiotic_sensitivity" class="mw-redirect" title="Antibiotic sensitivity">Antibiotic sensitivity</a></li>

<li><a href="Antimicrobial_resistance" title="Antimicrobial resistance">Antimicrobial resistance</a>

<ul><li><a href="Multiple_drug_resistance" title="Multiple drug resistance">multidrug</a></li></ul></li>

<li><a href="Antibiotic_prophylaxis" title="Antibiotic prophylaxis">Antibiotic prophylaxis</a></li>

<li><a href="Empiric_therapy" title="Empiric therapy">Empiric therapy</a></li>

<li><a href="Directed_therapy" title="Directed therapy">Directed therapy</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Social issues</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Antimicrobial_stewardship" title="Antimicrobial stewardship">Antimicrobial stewardship</a></li>

<li><a href="Antibiotic_misuse" title="Antibiotic misuse">Antibiotic misuse</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Pharmacology</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Antimicrobial_pharmacodynamics" title="Antimicrobial pharmacodynamics">Antimicrobial pharmacodynamics</a></li>

<li><a href="List_of_antibiotics" title="List of antibiotics">List of antibiotics</a></li>

<li><a href="Production_of_antibiotics" title="Production of antibiotics">Production of antibiotics</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Agriculture</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Antibiotic_use_in_livestock" title="Antibiotic use in livestock">Antibiotic use in livestock</a></li>

<li><a href="Antibiotics_in_poultry_farming_in_America" class="mw-redirect" title="Antibiotics in poultry farming in America">Antibiotics in poultry farming in America</a></li>

<li><a href="Subtherapeutic_antibiotic_use_in_swine" title="Subtherapeutic antibiotic use in swine">Subtherapeutic antibiotic use in swine</a></li>

<li><a href="Pesticide_resistance" title="Pesticide resistance">Pesticide resistance</a></li></ul>

</div></td></tr></tbody></table></div>

<div class="navbox-styles"></div><div role="navigation" class="navbox" aria-labelledby="Techniques_in_clinical_microbiology192" style="padding:3px"><table class="nowraplinks mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Techniques_in_clinical_microbiology192" style="font-size:114%;margin:0 4em">Techniques in <a href="Clinical_microbiology" class="mw-redirect" title="Clinical microbiology">clinical microbiology</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Isolation_(microbiology)" title="Isolation (microbiology)">Isolation</a> and <a href="Culture_(microbiology)" class="mw-redirect" title="Culture (microbiology)">culture</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Isolation techniques</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Asepsis" title="Asepsis">Asepsis</a></li>

<li><a href="Streaking_(microbiology)" title="Streaking (microbiology)">Streak plate</a></li>

<li><a href="Selective_media" class="mw-redirect" title="Selective media">Selective media</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Cultures by body site</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Blood_culture" title="Blood culture">Blood culture</a></li>

<li>Genital culture</li>

<li><a href="Sputum_culture" title="Sputum culture">Sputum culture</a></li>

<li><a href="Throat_culture" title="Throat culture">Throat culture</a></li>

<li><a href="Urine_culture" class="mw-redirect" title="Urine culture">Urine culture</a></li>

<li><a href="Wound_culture" class="mw-redirect" title="Wound culture">Wound culture</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Cultures by organism</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Bacterial_culture" class="mw-redirect" title="Bacterial culture">Bacterial culture</a></li>

<li>Fungal culture</li>

<li><a href="Viral_culture" title="Viral culture">Viral culture</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Microbiological_identification" class="mw-redirect" title="Microbiological identification">Identification</a> and testing</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Manual testing: basic techniques</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Colonial_morphology" title="Colonial morphology">Colonial morphology</a>

<ul><li><a href="Hemolysis_(microbiology)" title="Hemolysis (microbiology)">Hemolysis</a></li></ul></li>

<li><a href="Staining_(biology)" class="mw-redirect" title="Staining (biology)">Staining</a>

<ul><li><a href="Gram_stain" title="Gram stain">Gram stain</a></li>

<li><a href="Acid-fast_stain" class="mw-redirect" title="Acid-fast stain">Acid-fast stain</a></li>

<li><a href="Giemsa_stain" title="Giemsa stain">Giemsa stain</a></li>

<li><a href="India_ink_stain" class="mw-redirect" title="India ink stain">India ink stain</a></li>

<li><a href="Ziehl%E2%80%93Neelsen_stain" title="Ziehl–Neelsen stain">Ziehl–Neelsen stain</a></li></ul></li>

<li>Rapid tests

<ul><li><a href="Oxidase_test" title="Oxidase test">Oxidase</a></li>

<li><a href="Catalase_test" class="mw-redirect" title="Catalase test">Catalase</a></li>

<li><a href="Indole_test" title="Indole test">Indole</a></li>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Manual testing: biochemical and immunologic tests</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<li>Amino acid decarboxylase test</li>

<li><a href="Bile_solubility_test" class="mw-redirect" title="Bile solubility test">Bile solubility test</a></li>

<li><a href="Citrate_test" title="Citrate test">Citrate test</a></li>

<li><a href="Coagulase_test" class="mw-redirect" title="Coagulase test">Coagulase test</a></li>

<li><a href="Diagnostic_microbiology#DNA_hydrolysis" title="Diagnostic microbiology">DNAse test</a></li>

<li><a href="IMViC" title="IMViC">IMViC</a></li>

<li><a href="Methyl_red_test" class="mw-redirect" title="Methyl red test">Methyl red test</a></li>

<li><a href="Diagnostic_microbiology#Nitrite_test" title="Diagnostic microbiology">Nitrite test</a></li>

<li><a href="Oxidative/fermentation_glucose_test" title="Oxidative/fermentation glucose test">Oxidative/fermentation glucose test</a></li>

<li><a href="Phenylalanine_deaminase_test" class="mw-redirect" title="Phenylalanine deaminase test">Phenylalanine deaminase test</a></li>

<li><a href="Diagnostic_microbiology#Reverse_CAMP_test" title="Diagnostic microbiology">Reverse CAMP test</a></li>

<li><a href="Diagnostic_microbiology#6.5%_salt_broth" title="Diagnostic microbiology">Salt tolerance test</a></li>

<li><a href="Sulfide_indole_motility_test" class="mw-redirect" title="Sulfide indole motility test">Sulfide indole motility test</a></li>

<li><a href="Triple_sugar_iron_test" class="mw-redirect" title="Triple sugar iron test">Triple sugar iron test</a></li>

<li><a href="Urease#As_diagnostic_test" title="Urease">Urease test</a>

<ul><li><a href="Rapid_urease_test" title="Rapid urease test">rapid</a></li></ul></li>

<li><a href="Voges%E2%80%93Proskauer_test" title="Voges–Proskauer test">Voges–Proskauer test</a></li>

<li>X and V factor test</li>

<li>Bacitracin susceptibility test</li>

<li><a href="Optochin_susceptibility_test" class="mw-redirect" title="Optochin susceptibility test">Optochin susceptibility test</a></li>

<li><a href="Novobiocin_susceptibility_test" class="mw-redirect" title="Novobiocin susceptibility test">Novobiocin susceptibility test</a></li>

<li><a href="Lancefield_grouping" title="Lancefield grouping">Lancefield grouping</a></li>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Automated and <a href="Point-of-care_testing" title="Point-of-care testing">point-of-care testing</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Analytical_profile_index" title="Analytical profile index">Analytical profile index</a></li>

<li><a href="MALDI-TOF" class="mw-redirect" title="MALDI-TOF">MALDI-TOF</a></li>

<li><a href="Polymerase_chain_reaction#Infectious_disease_applications" title="Polymerase chain reaction">Polymerase chain reaction</a></li>

<li><a href="VITEK" title="VITEK">VITEK</a></li>

<li><a href="Rapid_strep_test" title="Rapid strep test">Rapid strep test</a></li>

<li><a href="Monospot_test" class="mw-redirect" title="Monospot test">Monospot test</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Antibiotic_sensitivity" class="mw-redirect" title="Antibiotic sensitivity">Antibiotic susceptibility testing</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li>Beta-lactamase test</li>

<li><a href="Disk_diffusion_test" title="Disk diffusion test">Disk diffusion test</a></li>

<li><a href="Etest" title="Etest">Etest</a></li>

<li><a href="McFarland_standards" title="McFarland standards">McFarland standards</a></li>

<li><a href="Minimum_inhibitory_concentration" title="Minimum inhibitory concentration">Minimum inhibitory concentration</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Equipment</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Agar_plate" title="Agar plate">Agar plate</a>

<ul><li><a href="Growth_medium" title="Growth medium">Growth medium</a></li></ul></li>

<li><a href="McIntosh_and_Filde's_anaerobic_jar" class="mw-redirect" title="McIntosh and Filde's anaerobic jar">Anaerobic jar</a>

<li><a href="Durham_tube" title="Durham tube">Durham tube</a></li>

<li><a href="Biosafety_cabinet" title="Biosafety cabinet">Biosafety cabinet</a></li>

<li><a href="Incubator_(culture)" title="Incubator (culture)">Incubator</a></li>

<li><a href="Inoculation_loop" title="Inoculation loop">Inoculation loop</a></li>

<li><a href="Inoculation_needle" title="Inoculation needle">Inoculation needle</a></li></ul>

</div></td></tr></tbody></table></div></div><div><div class="zim-footer">

This article is issued from <a class="external text" title="Last edited on 2025-07-19" href="https://en.wikipedia.org/wiki/?title=Antibiotic_sensitivity_testing&oldid=1301319467">Wikipedia</a>. The text is available under <a class="external text" href="https://creativecommons.org/licenses/by-sa/4.0/deed.en">Creative Commons Attribution-Share Alike 4.0</a> unless otherwise noted. Additional terms may apply for the media files.

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