Antibiotic susceptibility test was done by disc diffusion method following the guidelines of Clinical and Laboratory Standards Institute (CLSI) using commercially available antibiotic disc (Oxoid, Basingstoke, United Kingdom). The antibiotic discs used in this study were ampicillin (Amp; 10 µg), sulphamethoxazole-trimethoprim (Sxt; 25 µg), mecillinam (Mel; 25 µg), nalidixic acid (Na; 30 µg), ciprofloxacin (Cip; 5 µg), norfloxacin (Nor; 10 µg), ofloxacin (Of; 5 µg), azithromycin (Azm; 15 µg), and ceftriaxone (Cro; 30 µg) [24] . The minimum inhibitory concentrations (MICs) of nalidixic acid, ciprofloxacin, norfloxacin, ofloxacin, azithromycin, and ceftriaxone were determined by the E-test (AB Biodisk, Solna, Sweden).
Ciprofloxacin
Manufactured by bioMérieux
Sourced in France, Sweden, United Kingdom
Ciprofloxacin is a laboratory equipment product manufactured by bioMérieux. It is a fluoroquinolone antibiotic used for the identification and susceptibility testing of bacteria in clinical samples.
Automatically generated - may contain errors
Lab products found in correlation
Amikacin, by bioMérieux (10 mentions)
Ceftriaxone, by bioMérieux (9 mentions)
Etest, by bioMérieux (9 mentions)
Imipenem, by bioMérieux (8 mentions)
Gentamicin, by bioMérieux (8 mentions)
Nalidixic acid, by bioMérieux (7 mentions)
Cefepime, by bioMérieux (7 mentions)
Meropenem, by bioMérieux (5 mentions)
Ceftazidime, by bioMérieux (5 mentions)
Cefotaxime, by bioMérieux (5 mentions)
Azithromycin, by bioMérieux (4 mentions)
Tobramycin, by bioMérieux (4 mentions)
Levofloxacin, by bioMérieux (4 mentions)
Ertapenem, by bioMérieux (4 mentions)
Piperacillin, by bioMérieux (3 mentions)
Tetracycline, by bioMérieux (3 mentions)
Amoxicillin, by bioMérieux (3 mentions)
Tigecycline, by bioMérieux (3 mentions)
Ciprofloxacin, by Thermo Fisher Scientific (3 mentions)
Gentamicin, by BD (2 mentions)
25 protocols using ciprofloxacin
1
Antibiotic Susceptibility Testing of Bacterial Isolates
2
Antibiotic Susceptibility Testing Protocol
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The antimicrobial susceptibility testing for different antibiotic agents (piperacillin (100 μg), cefotaxime (30 μg), cefoxitin (30 μg), aztreonam (30 μg), meropenem (10 μg), ciprofloxacin (5 μg), ofloxacin (5 μg), amikacin (30 μg), gentamicin (10 μg), tigecycline (15 μg), and trimethoprim/sulfamethoxazole (1.25 μg /23.75 μg) (BD Diagnostics, Franklin Lakes, NJ, USA) was done by the Kirby-Bauer standard disk diffusion method. The MIC values (mg/L) of meropenem and ciprofloxacin were determined using Etest (AB Biodisk, Solna, Sweden). All the values were interpreted according to CLSI guidelines [9 ] except for tigecycline, which was interpreted according to EUCAST guidelines 2013 [10 ]. MIC50 and MIC90 (MIC at which 50 and 90% of the isolates were inhibited respectively) were calculated for meropenem and ciprofloxacin.
3
Antibiotic Resistance Profiling of P. aeruginosa
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Following the recommendations of the European Committee on Antimicrobial Susceptibility Testing (EUCAST) (EUCAST 2019 ), both P. aeruginosa isolates were tested against the following antibiotic discs using the disc diffusion method. The multidrug discs contained ciprofloxacin (5 µg), piperacillin (100 µg), imipenem (10 µg), cefepime (30 µg), fosfomycin (200 µg), colistin (10 µg), and tobramycin (10 µg) (AB Biodisk, UK). The zones of inhibition (ZoI) were measured in millimetres following 12–18 h incubation at 37 °C, and interpreted in accordance with the manufacturer’s recommendations. Bacterial isolates were designated as antibiotic resistant (AMR) if they were resistant to multiple antimicrobial agents, classes, or subclasses of antibiotics as defined by EUCAST (Magiorakos et al. 2012 (link)).
4
Antibiotic Susceptibility of E. coli
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The E coli isolates were subjected to antibiotic susceptibility testing by modified Kirby-Bauer disk diffusion method on Mueller-Hinton agar plates as per the Clinical and Laboratory Standards Institute (CLSI) guidelines.46 The commercially available minimum inhibitory concentration (MIC) strips containing the following antimicrobials were tested for the DEC isolates: ampicillin, piperacillin, levofloxacin, ciprofloxacin, ampicillin-sulbactam, piperacillin-tazobactam, amikacin, cefoxitin, gentamicin, ceftazidime, cefotaxime, ceftriaxone, cefepime, aztreonam, imipenem, and meropenem (AB Biodisk, Solna, Sweden). The strips were aseptically placed on the surfaces of the sensitivity agar plates and these were incubated for 18 to 24 hours at 37°C. The MIC values (mg/L) were determined (MIC50 and MIC90 were calculated as the MIC point at which 50% and 90% of the isolates were inhibited) and interpreted according to CLSI guidelines as modified in 2013.
5
Antimicrobial Susceptibility of ETEC
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Antimicrobial agents from Oxoid, Basingstoke, United Kingdom were used to determine bacterial susceptibility by using the guidelines of National Committee for Clinical Laboratory Standards [36 ]. The antibiotic discs used in the study included ampicillin (10 μg), azithromycin (15 μg), ceftriaxone (30 μg), ciprofloxacin (5 μg), doxycycline (30 μg), erythromycin (15 μg), mecillinam (25 μg), nalidixic acid (30 μg), norfloxacin (10 μg), streptomycin (10 μg), sulfomethoxazole-trimethoprim (25 μg) and tetracycline (30 μg). The minimum inhibitory concentrations (MIC) of nalidixic acid, ciprofloxacin, and azithromycin were determined by the E-test (AB Biodisk, Solna, Sweden) according to the NCCL guideline. E. coli ATCC 25922, susceptible to all antimicrobials was used as a control strain for susceptibility studies. We performed antibiogram of all ETEC strains collected during the study period and randomly selected the representative nalidixic acid and ciprofloxacin resistant strains. These strains were compared with a few representative nalidixic and ciprofloxacin susceptible strains for genotyping.
6
Antimicrobial Susceptibility of Pseudomonas aeruginosa
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The isolated JNQH-PA57 was grown in Mueller-Hinton agar (MHA) (Oxoid, Hampshire, United Kingdom) at 37 °C for 24 h. The species identification was determined with Microflex LT/SH MALDI-TOF mass spectrometer (Bruker, Germany). The antimicrobial susceptibility of this stain was performed using MIC evaluation via the E-test method for the following antimicrobial agents: piperacillin, piperacillin/tazobactam, ticarcillin/clavulanic acid, ceftazidime, cefepime, aztreonam, imipenem, meropenem, amikacin, tobramycin, levofloxacin, ciprofloxacin, according to the manufacturer’s guidelines (AB Biodisk, Sweden). For colistin, the MIC was determined via a broth microdilution method, according to the Clinical and Laboratory Standards Institute (CLSI) guideline. P. aeruginosa ATCC 27853 served as a quality control strain for susceptibility testing. The interpretation of the results was based on the CLSI 2020 guideline [55 ].
7
Antimicrobial Susceptibility of Shigella spp.
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Antimicrobial susceptibility was performed on all Shigella spp. by Kirby-Bauer disc diffusion method on Muller-Hinton agar medium (Merck, Germany), according to the guidelines of the Clinical and Laboratory Standards Institute [ 8 ]. The antibiotic included ceftriaxone (30 μg), trimethoprim/sulfamethoxazole (1.25/23.75 μg), amikacin (30 μg), gentamycin (10 μg), ceftazidime (30 μg), cefotaxime (30 μg), ciprofloxacin (5 μg), azithromycin (15 μg), and ampicillin (10 μg) (Mast Ltd., UK.). Also, E. coli ATCC 25922 was used as the control strain. The phenotype of Shigella spp. was defined as MDR according to the International Expert proposal for Interim Standards Guidelines[ 9 ]. The minimum inhibitory concentrations (MICs) for ceftriaxone, ceftazidime, cefotaxime, ciprofloxacin, amikacin, and gentamicin were determined by E-test (AB Biodisk, Sweden).
8
Antimicrobial Resistance Profiling
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Antimicrobial susceptibility testing was performed using the Clinical and Laboratory Standards Institute (CLSI) disc diffusion method and interpreting zone diameters in accordance with CLSI guidelines in WHONET software version 5.346 (link). Discs used contained ampicillin (10 µg/ml), streptomycin (10 µg), trimethoprim (5 µg), tetracycline (30 µg), nalidixic acid (30 µg), chloramphenicol (300 µg), sulphonamide (1000 µg) and ciprofloxacin (5 µg) (Oxoid/Remel). E. coli ATCC 35218 and DH5αE (Invitrogen) were used as control strains. Minimum inhibitory concentrations (MICs) for nalidixic acid and ciprofloxacin were determined using E-test (bioMérieux) on Mueller-Hinton (MH) agar. Kanamycin MICs were determined by agar dilution on Mueller-Hinton Agar.
9
Antibiotic Susceptibility Profiling of Staphylococcus
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Susceptibility to penicillin G, gentamicin, rifampin, ciprofloxacin, clindamycin, erythromycin, chloramphenicol, tetracycline, linezolid, and vancomycin (National Institutes for Food and Drug Control, China) were tested by agar dilution method as described by Wiegand et al.23 In addition, the E‐test method was used to determine the MICs of all isolates for sulfamethoxazole/ trimethoprim (SXT) (bioMérieux, France). Mueller‐ Hinton agar (MHA) plates were inoculated by streaking the standardized inocula (0.5 McFarland, approximately 1.5 × 108 CFUs/mL) using a sterile swab. The SXT E‐test strips (bioMérieux, France) were placed on the plates, followed by incubation at 35°C for 16–20 h. The minimal inhibitory concentration (MIC) reading for both the E‐test and agar dilution methods was conducted independently by a senior experimenter, with the result confirmed by a second reader. The MIC results were interpreted according to the Clinical and Laboratory Standards Institute (CLSI) breakpoints for Staphylococcus spp.24 Staphylococcus aureus ATCC29213 was used as a quality control. MDR was defined as isolates resistant to ≥3 classes of non‐β‐lactam antimicrobials.
10
Antibiotic Susceptibility Profiling
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Antibiotic susceptibility was determined on Mueller–Hinton agar using the standard disk diffusion method, as described by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) 2017 and also using the Phoenix system. Seventeen antibiotics (bioMérieux, Marcy L’Etoile, France) were tested, namely, amoxicillin (AMX), amoxicillin/clavulanate (AMC), piperacillin/tazobactam (PTZ), cephalothin (CEF), ceftriaxone (CRO), cefepime (CPM), ertapenem (ETP), imipenem (IMP), amikacin (AMK), gentamicin (GEN), ciprofloxacin (CIP), Fosfomycin (FOS), nitrofurantoin (NIT), doxycycline (DCI), trimethoprim/sulfamethoxazole (SXT) and colistin (CS). Sensitivity to imipenem, ertapenem, meropenem (MEM) and colistin was confirmed by the antimicrobial gradient method Etest (bioMérieux, Marcy L’Etoile, France) in collected isolates.
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