Accuracy and reproducibility of the Etest to detect drugresistant Neisseria gonorrhoeae to contemporary treatment

John R. Papp, Marie Claire Rowlinson, Norman P. O’Connor, Jason Wholehan, Jafar H. Razeq, Anita Glennen, Dapne Ware, Peter C. Iwen, Lillian V. Lee, Celia Hagan

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Purpose. Neisseria gonorrhoeae is a sexually transmitted bacterial pathogen that continues to evolve to become resistant to known antibiotics. In preparing for potential emergence, the Centers for Disease Control and Prevention recommends that clinical laboratories maintain or develop protocols to assess antibiotic susceptibly for this organism. This study examines the intra-laboratory variability of using the Etest method to provide consistent MIC values for N. gonorrhoeae and also compared the results of the Etest to known agar dilution MIC values. Methodology. Clinical N. gonorrhoeae isolates, 100 paired duplicates, were tested by eight laboratories for antibiotic susceptibility to ceftriaxone, cefixime and azithromycin using Etest strips. Results/Key findings. Overall, >80% of the paired Etest MIC values were within one log2dilution of the replicate. When compared to the agar dilution reference method, the cefixime Etest MIC values were consistently underreported by one dilution (seven laboratories) or two dilutions (one laboratory). The azithromycin Etest MIC values agreed 90.7% with the agar dilution MIC values while the agreement with ceftriaxone was 90.9 %. Conclusion. Overall, the Etest method yielded reproducible MIC values within each laboratory with the azithromycin and ceftriaxone MIC results consistent to the reference agar dilution method while the cefixime result tended to provide a lower MIC value.

Original languageEnglish (US)
Article number000651
Pages (from-to)68-73
Number of pages6
JournalJournal of Medical Microbiology
Issue number1
StatePublished - Jan 2018


  • Antimicrobial susceptibility
  • Etest accuracy
  • Etest reproducibility
  • Gonorrhea

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)


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