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image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Journal of Antimicro...arrow_drop_down
image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
Journal of Antimicrobial Chemotherapy
Article . 2025 . Peer-reviewed
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Comparative evaluation of disc diffusion and Liofilchem™ MTS strip methods with broth microdilution for cefepime/enmetazobactam susceptibility testing

Authors: Cécile Emeraud; Hippolyte De Swardt; Sandrine Bernabeu; Lena Latour; Alice Pages; Sarah Ronsin; Rémy A Bonnin; +1 Authors

Comparative evaluation of disc diffusion and Liofilchem™ MTS strip methods with broth microdilution for cefepime/enmetazobactam susceptibility testing

Abstract

Abstract Background Cefepime/enmetazobactam is a newly approved β-lactam/β-lactamase inhibitor combination with promising activity against MDR Gram-negative Enterobacterales, particularly ESBL- and OXA-48-producing isolates. Reliable susceptibility testing methods are essential to guide its clinical use. Objectives To evaluate the performance of two commercial cefepime/enmetazobactam susceptibility testing methods, disc diffusion and Liofilchem™ MTS gradient strips, using broth microdilution (BMD) as the gold standard. Methods A total of 291 carbapenem-resistant Enterobacterales isolates, including 194 carbapenemase producers, were included. Susceptibility testing was performed using BMD, disc diffusion and Liofilchem™ MTS strips. Results were interpreted following EUCAST and FDA 2025 breakpoints. Essential agreement (EA) and bias were calculated for gradient strip methods according to the ISO 20776-2021 guideline, whereas categorical agreement (CA), very major errors (VMEs) and major errors (MEs) were determined for disc diffusion according to the ISO 20776-2:2007 guideline. Results The disc diffusion method demonstrated high CA (93.8% EUCAST, 95.9% FDA). VME rates exceeded acceptable thresholds using EUCAST breakpoints (20.8%) but were within limits for FDA (1.9%). Liofilchem™ MTS strips achieved 88.3% (95% CI: 84.1%–91.5%) EA and a bias of −8.9%. Both methods accurately detected susceptibility in OXA-48-producing isolates but showed limitations for isolates close to the MIC breakpoints. Conclusions Disc diffusion and Liofilchem™ MTS strips represent reliable alternatives to BMD for routine cefepime/enmetazobactam testing.

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Keywords

Enterobacteriaceae, Disk Diffusion Antimicrobial Tests, Barbiturates, Humans, Microbial Sensitivity Tests, Triazoles, Cefepime, beta-Lactamase Inhibitors, Azabicyclo Compounds, Anti-Bacterial Agents, Cephalosporins

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
Average
Average
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