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Scientific
Publications - Work Done by Microbiology Reader Bioscreen C
Journal of Applied Microbiology, 2000, May,
88(5), 784-790
Susceptibility testing accurate and reproducible minimum
inhibitory concentration (MIC) and non-inhibitory concentration (NIC) values
Lambert RJ, Pearson J.
ABSTRACT
Measuring the minimum inhibitory concentration (MIC) of a substance by
current methods is straightforward, whereas obtaining useful comparative
information from the tests can be more difficult. A simple technique and a
method of data analysis are reported which give the experimentalist more useful
information from susceptibility testing. This method makes use of a 100-well
microtitre plate and the analysis uses all the growth information, obtained by
turbidometry, from each and every well of the microtitre plate. A modified
Gompertz function is used to fit the data, from which a more exact value can be
obtained for the MIC. The technique also showed that at certain concentrations
of inhibitor, there was no effect on growth relative to a control well (zero
inhibitor). Above a threshold value, which has been termed the non-inhibitory
concentration or NIC, growth becomes limiting until it reaches the MIC, where no
growth relative to the control is observed.
INTRODUCTION
A current definition of the Minimum Inhibitory Concentration,
MIC, is "the lowest concentration which resulted in maintenance or reduction of
inoculum viability" ( Carson et al. 1995). The determination of the MIC involves
a semi-quantitative test procedure which gives an approximation to the least
concentration of an antimicrobial needed to prevent microbial growth. In the
recent past, the method used tubes of growth broth containing a test level of
preservative, into which an inoculum of microbes was added. The end result of
the test was the minimum concentration of antimicrobial which gave a clear
solution, i.e., no visual growth ( Collins 1964; Davidson and Parish 1989).
Currently, the tubes have been replaced by a semi-automated microtitre method.
Where the turbidity of the test compound interferes with the test, indicators
can be used for the determination of the end-point. These include fluorescein
diacetate ( Chand et al. 1994) and resazurin ( Mann and Markham 1998). However,
the end-point of all experiments is still the observation of no growth in one of
the wells, interpreted as the MIC ( Sommers 1980).
The lack of a quantitative standard method has hampered many
studies into the action of antimicrobials ( Janssen et al. 1987; Manou et al.
1998). However, the principle problem encountered is that all MIC techniques
currently used are semi-quantitative. Tiina and Sandholm (1989) examined the
inhibition of micro-organisms with glucose oxidase/glucose. Using turbidometry,
they related the area under the O.D./time curves to the degree of inhibition
observed using the ratio of growth of a control to that of the test. A study was
carried out to determine whether this basic idea could be used to obtain
accurate MIC values, for a given set of conditions, for a range of common
antimicrobial substances.
MATERIALS, MICROBES AND METHODS
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Preparation of bacterial suspensions for testing
Staphylococcus aureus ATCC 6538, Escherichia coli ATCC
11229 and Pseudomonas aeruginosa ATCC 2730 were grown overnight in
flasks containing 80 ml Tryptone Soya Broth, TSB (Oxoid), with shaking, at
30 °C. The culture was centrifuged at 4000 rev min
1
(510 g , Sigma, Harz, Germany; model 3K-1) for 10 min. The
resulting cell pellets were pooled and resuspended in 0·1% peptone water. In
general, an inoculum level of approximately 1 107
ml
1
was used, which was made reproducible through the use of a calibration
standard produced from an investigation of O.D. readings and plate count
numbers. |
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Method of analysis
This method of setting up the experiment was designed to minimize the
amount of work required by the operator, and a 200-well test (2 100
wells) could be prepared in under 2 h, given the availability of the
microbes. The tests were carried out on a Bioscreen Microbiological Growth
Analyser (Labsystems, Helsinki, Finland), and the experimental set up was
based on the use of the non-standard, 100-well plates manufactured for this
machine. However, any O.D. reader, or any other machine capable of giving an
output signal based on a growth criterion, can be used with suitable
modifications to the experimental design.
A stock solution of the antimicrobial under test was prepared in the
microbial growth medium being used. From the stock solution, nine
'principle' dilutions were made using the growth medium. The recommended
dilutions are from 1 to 0·2 fractional dilutions, e.g. 4 ml stock plus 6 ml
growth broth giving the 0·4 dilution fraction. The first column of the plate
received 250 µl of growth broth. To the first wells of each remaining column
were added 500 µl of a principle dilution. All the other wells received
250 µl of growth broth (assuming a twofold dilution series); 250 µl of a
principle dilution was then added to the next well in the appropriate column
and mixed, and the dilution series continued to the end of the column.
Each well, except for one of the controls (well 10), in column one
received 50 µl of the prepared inoculum. The plate was then incubated at the
desired temperature and time, with the analyser recording the O.D. of each
well at 600 nm every 10 min. |
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Analysis
The basis of the technique is the comparison of the area under the
O.D./time curve of the control with the areas of the tests (the nine
controls, wells 1-9, are averaged and the background, well 10, is removed
from the data). As the amount of preservative in a well increases, the
effect on the growth of the organism also increases. This effect on growth
is manifested by a reduction in the area under the O.D./time curve relative
to a control well at any specified time. By calculating the area under the
O.D./time curves using the trapezoidal rule, the relative amount of growth
can be obtained using the ratio of the test area to that of the control,
termed the fractional area, FA.
Using an available spreadsheet, the calculations and time required were
minimized with the use of the template which was developed. The template
received the raw data from the Bioscreen, and outputted the results in the
form of concentrations of preservative with the observed fractional areas. |
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Measurement of NIC and MIC: Fitting of a modified
Gompertz function
Data in the form of log concentration vs fractional area can be
analysed using a modified Gompertz equation (see Mackey and Derrick 1982 for
another example of its use). The altered Gompertz function, in this case,
relates the fractional area (y) to the log of antimicrobial concentration
(x), Eq. 1.
where A is the lower asymptote of y (approximately zero), B is a slope
parameter, C is the distance between the upper and lower asymptote
(approximately 1) and M is the log concentration of the inflexion point. The
values of the NIC and MIC are defined as the intersection of the lines y = A + C
and y = A, with the equation of the line tangential to the point (M,
(A + Ce
1)),
respectively.
The values of A, C, B and M are obtained from a non-linear fitting
procedure, commonly found on statistical packages such as JMP (SAS
Institute, Cary, NC, USA). |
RESULTS
| following experiments have been picked
to show the utility of the methodology. Table 1 summarizes the data
obtained. |
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Dodecylpyridinium chloride and Staphylococcus
aureus
The 100-well plate of the Bioscreen was set up to give a range of
dilutions from 83 to 0·03 ppm. Incubation was carried out for just under
18 h. The data obtained were transformed into fractional areas and plotted
against concentration, Fig. 1.
In general, plotting the inhibitor concentration on a logarithmic scale
gives a characteristic sigmoid-shaped curve. The curve can be split into
three principle regions: a region where the presence of the preservative has
no effect on the of the organism relative to the control growth (as measured
by O.D.), a region where there is increasing inhibition of growth, and a
region where there is no measurable growth relative to the control. Terms
have been assigned to two specific concentrations, the non-inhibitory
concentration, NIC, the concentration above which the inhibitor begins to
have a negative effect on growth, and the minimum inhibitory concentration,
MIC, which marks the concentration above which no growth is observed
relative to the control. |
|
CnH2nN(Me3) Br; n = 8,
10, 12, 14, 16, 18; against Staphylococcus aureus and Pseudomonas
aeruginosa
The straight alkyl chain trimethyl ammonium bromide surfactants (CnQAC)
were examined. Figure 2 displays the observed and fitted inhibition profiles
for a range CnQAC compounds against Staph. aureus. A plot of chain
length against the log MIC and log NIC values gave a stepwise drop in
susceptibility from n = 8 to 14, Fig. 3. A maximum level of
inhibition was obtained at n = 16; thereafter, a decrease in
susceptibility was found. In the case of Ps. aeruginosa, a stepwise
drop in the log MIC and log NIC values was observed up to n = 14. For
chain lengths of n = 16 and 18, complex inhibition profiles were
found e.g. Figure 4. |
|
Phenethyl alcohol and phenoxyethanol against
Staphylococcus aureus
Phenethyl alcohol, PeA, is described as a poorer inhibitor than
phenoxyethanol, PoE ( Paulus 1993). An inhibition study was conducted under
the same conditions of temperature and inoculum challenge. Under these
conditions, it was found that PeA had the lower MIC ( Table 1). The slight
difference in molecular weight (122·2 vs 138·2 for PeA and PoE,
respectively) cannot account for the 2000 ppm difference between the MIC
values. |
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Reproducibility
Dodecylcholine is a quaternary ammonium analogue, but unlike the
quaternary ammonium compounds (QACs) used regularly in disinfection, the
alkanoylcholines have an expected low toxicity due to an ester link which
connects the alkyl chain with the choline moiety. The modified Gompertz
analysis of five separate inhibition investigations against Staph. aureus,
done on different days by different operators, gave an NIC = 6·16 ± 0·45 ppm
and an MIC = 10·09 ± 1·04 ppm. The inoculum challenge for these experiments
ranged from 0·9 107
to 1·59 107
organisms ml
1. |
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Rapidity of the technique
Minimum inhibitory concentration experiments are generally carried out
over a specified time, e.g. 24 h. As this technique is based on growth
relative to a control, it should allow an estimation of an MIC at any time
up to the point of the test termination. In this laboratory, many of the
experiments are terminated after 18 h, allowing time for data analysis and
the setting up of another experiment(s) based on those results. An analysis
of the calculated NIC and MIC values of the inhibition of C14QAC against
Staph. aureus, with respect to incubation time, was carried out. The NIC
and MIC values were calculated every hour, after an initial 4 h incubation,
up to the end of the test. The results are shown in Fig. 5. The figure
clearly shows a rise in the MIC as incubation time increases, commensurate
with an increase in the NIC. Below about 8 h of incubation, the signal to
noise ratio of the control wells is low, resulting in large FA values. The
time taken for a substantial increase in the signal to noise ratio will be
dependent on the inoculum size and the specific growth rate of the organism. |
DISCUSSION
| Minimum inhibitory concentration is a
difficult subject. The traditional methods of analysis do not allow a
quantitative measurement; MIC is, in effect, a range of concentrations
depending on the dilution series used. Measurement of the MIC should be a
first line technique of discovery for the biocide and preservative
scientist, but in many laboratories, it is used as an indicator of activity
rather than something of real substantive value. Further, comparison of
values obtained from the multitude of different techniques is problematic (
Skytta and Mattila-Sandholm 1991). Current turbidometric techniques fail to
provide good quantitative data because they do not use all the available
data. These techniques are often simply extensions of the tube dilution
series method into microtitre wells. The demarcation between growth/no
growth is examined, and the concentration of inhibitor in the well with no
growth is termed the MIC. All the growth information below the MIC
concentration is normally discarded.
By examining all the data from the 'basic' MIC dilution technique, it has
been possible to place a value on the data normally rejected. Furthermore,
it has been found that these data can lead to the placing of an accurate MIC
value on the antimicrobial, and also, a value on the non-inhibitory
concentration, the NIC, the concentration below which normal growth is
observed. |
|
Definition
Within the context of the work described here there are two working
definitions of MIC: one is that the MIC is the minimum concentration
required to prevent growth in the broth relative to a control and is in line
with the definition of Carson (1995); the other is based on the
extrapolation of a tangent from the inflexion point of a fitted Gompertz
curve to a lower asymptote (the zero-growth line). The former is a more
comfortable definition, whereas the latter is easy to calculate and use and
is less prone to experimental or subjective operator error.
The MIC (and the NIC) are dependent on the conditions under which the
experiment was run. These conditions should be specified when reporting the
results. The most important conditions that have been observed are the
incubation temperature, the organism and the inoculum size used, and a
fuller examination of these factors will be reported in the near future. |
|
Inhibitor concentration
NIC
The NIC is the concentration above which the inhibiting substance begins
to have an observable effect on growth. At concentrations below the NIC,
growth occurs at a pace equal to the control. The population of microbes is
unaffected by the presence of the test substance. In some instances, the FA
may exceed one if the test inhibitor leads to better growth conditions than
the control. Thus, this methodology could be used for the optimization of
growth media as an FA greater than one implies better growth conditions. |
|
NIC
inhibitor concentration
MIC
Between the two principle concentrations, growth inhibition occurs. The
observed inhibition can have many causes, e.g. a poisoning of the microbial
system leading to a slowing down of growth in a dose-dependent manner, or
the induction of apparent lags caused by the immediate cessation of growth
(see Lambert and Stratford 1999; for a discussion of weak acid- induced
lags). In many of the cases examined here, there is a linear relationship
between FA and inhibitor concentration between the NIC and the MIC. This is
suggestive of a single, encompassing mechanism of inhibition. In others,
however, such as the long-chain cationic surfactants, there appears to be a
biphasic inhibition suggestive of a complex inhibition mechanism. In the
case of Ps. aeruginosa and C16QAC, after an initial decrease in FA,
increasing amounts of inhibitor lead to an increase in the FA. It is
believed that this experiment (which has been repeated many times) is
suggesting a link between the MIC and the critical micelle concentration,
CMC, of the surfactant.
Devinsky et al. (1985, 1991) have shown that there is a
relationship between the MIC and CMC of quaternary ammonium compounds.
Optimum antimicrobial activity of surfactants is strongly related to the
ability to form micelles. Essentially, a micelle represents a
microbially-inactive form of the surfactant. The lower the CMC, the less
free-bulk surfactant available to interact with the microbial membrane. Our
hypothesis to explain the inhibition profile shown in Fig. 4 is that
premicellization occurs between membrane components of the Gram-negative
bacterium and the surfactant biocide. This essentially reduces the effective
concentration of the biocide in solution and thus, there is an increase in
the FA. As the CMC of the surfactant is approached (416 mg l
1,
Mukerjee and Mysels (1971)), this effect reaches a maximum. This effect may
be one of the causes of 'blebbing' ( Jones et al. 1989). At
concentrations higher than the CMC, the membrane becomes solubilized by the
surfactant and lysis occurs. This phenomenon, in which a lower concentration
of inhibitor has a greater inhibitory effect on growth than at a higher
concentration, would have been undiscovered if this method of examining the
inhibition profile had not been adopted. |
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MIC
Inhibitor concentration
At the MIC, no growth relative to the control is recorded. In some cases,
the FA appears to increase past the MIC, but this can be related to an
increase in opacity caused by the inhibitor itself at the wavelength used.
If the MIC is obscured by the inhibitor in this way, then an adaptation of
the methodology of Mann and Markham (1998) may be prudent. The MIC is
defined by this method mathematically, based on the Gompertz equation. In
some cases, the unbridled use of the Gompertz will lead to inaccurate MIC
values. For example, the use of the modified Gompertz function with the data
shown in Fig. 4 would be unwise. In such cases, other approaches may have to
be adopted, such as truncating the data and fitting a regression line to
those data. The MIC is defined for a particular incubation time. Figure 5
shows that after about 10 h (dependent on initial inoculum size), this
method can provide an accurate NIC and MIC. Changes in both values can occur
with greater incubation times, and an examination of the rate of change in
the NIC and MIC with incubation time may also be prudent. |
FIGURES
Fig. 1 The inhibition
profile of dodecylpyridinium chloride against Staphylococcus aureus: ( ),
observe...
Fig. 2 Observed inhibition
profiles and fitted Gompertz models (dashed lines) for CnQAC, n = 8,10,12,14,...
Fig. 3 MIC and NIC
dependence on alkyl chain length for CnQAC, n = 8,10,12,14,16,18, against
Staphylococ...
Fig. 4 Inhibition profile
of C16QAC against Pseudomonas aeruginosa
Fig. 5 Examination in the
change of NIC and MIC with incubation time for C14QAC against
Staphylococcus...
Table 1 MIC and NIC values
(mg l
1)
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