Powered by OpenAIRE graph
Found an issue? Give us feedback
image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ https://doi.org/10.6...arrow_drop_down
image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
https://doi.org/10.64898/2025....
Article . 2025 . Peer-reviewed
License: CC BY
Data sources: Crossref
image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
Journal of Clinical Microbiology
Article . 2026 . Peer-reviewed
License: CC BY
Data sources: Crossref
versions View all 2 versions
addClaim

Poloxamer dilution as an on-demand alternative to agar dilution-based antimicrobial susceptibility testing

Authors: Matthew T. J. Uy; Andrea Kirmaier; Lindsey M. Rudtner; Aidan Pine; James E. Kirby;

Poloxamer dilution as an on-demand alternative to agar dilution-based antimicrobial susceptibility testing

Abstract

Abstract Agar dilution is a reference susceptibility testing method uniquely or preferentially recommended for certain antimicrobials. However, the effort required to pour individual agar plates spanning a doubling dilution range precludes its practical implementation in hospital clinical laboratories. Here, we describe an on-demand replacement for agar dilution (AD), specifically substituting poloxamer 407 (also known as Pluronic F-127) for Bacto Agar as the solidifying agent. Notably, 20% poloxamer 407 solutions (e.g., with Mueller-Hinton broth) remain liquid at refrigerated temperatures, but solidify upon warming, enabling facile set-up of poloxamer dilution testing (PD) in Petri dish or microwell format. For fosfomycin susceptibility testing, PD and reference agar dilution (AD) showed excellent categorical (CA) and essential (EA) agreement for E. coli (100% and 87%, respectively, n=31). For other Enterobacterales, excluding Klebsiella spp; CA and EA were both 82% (n=17, respectively). For P. aeruginosa , CA and EA were 60% and 100% (n=10), respectively, with the lower CA reflecting the large number of strains tested with MICs near categorical breakpoints. There were no very major errors, while major errors were only observed for Klebsiella spp. Additionally, PD substantially reduced the number of skipped dilutions 6-fold for E. coli (P < 0.0001) and inhibited swarming of Proteus species. We conclude that PD and AD, an imperfect gold standard, have essentially equivalent practical performance and that PD can therefore serve as an on-demand alternative testing methodology in clinical laboratories for fosfomycin testing of gram-negative pathogens. A broader exploration of PD’s utility is thus warranted. Importance Accurate antibiotic susceptibility testing is essential for guiding treatment of bacterial infections. For the antibiotic fosfomycin, used to treat Escherichia coli urinary tract infections, the most reliable testing method requires solid media prepared by hand for each antibiotic concentration, which is too time consuming for most clinical laboratories to perform. Our study shows that replacing agar with an alternative temperature-sensitive gelling agent called poloxamer enables laboratories to prepare solid test plates rapidly without special equipment. This approach, which is essentially identical to traditional agar dilution, provides a practical alternative that can be implemented by hospital clinical microbiology laboratories for accurate fosfomycin testing near the point of patient care. This strategy may also be applicable to other drugs for which agar dilution is the preferred testing method, supporting expedited testing to inform treatment decisions for bacterial infections.

  • BIP!
    Impact byBIP!
    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).
    0
    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.
    Average
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Average
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Average
Powered by OpenAIRE graph
Found an issue? Give us feedback
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!
0
Average
Average
Average
gold