Nitroxoline is one of the recommended first-line drugs for the treatment of uncomplicated urinary tract infections (uUTIs), but it is not included in the usual panels of automated susceptibility testing (AST) platform systems, such as MicroScan or Vitek. Therefore, manual testing of Nitroxoline using disc diffusion is required for routine diagnostics of urine specimens. With a resulting high number of tests to be interpreted manually, the potential impact of an automated inhibition measurement technology is particularly high.

In this study, 260 Escherichia coli isolates from routine urine samples were tested for susceptibility to Nitroxoline by disc diffusion testing, and zone diameter results from three interpretation methods were compared: manual plate-in-hand reads, APAS Independence (Clever Culture Systems) AI-Algorithms, and electronic reads by a microbiologist using APAS-generated images. The APAS Independence results showed high categorical agreement (253/260) with manual reads, with only 6 major errors, and 1 very major error which APAS flagged for review and thus was not released.

As no systematic error or difference between human reading and APAS reading was found, APAS-AMR is a promising tool for the automated measurement of zone diameters in the routine microbiological diagnostic.‍

Poster & Oral Presentation: Wisplinghoff Laboratories - Cologne, Germany

‍Conference: ECCMID 2023, Copenhagen, Denmark

‍Date: April 2023

‍Authors: Popsel, J., Nowag, A., Giglio, S., Hill, R., Wisplinghoff, H., and Jazmati, N.

‍Citation: Popsel, J., Nowag, A., Giglio, S., Hill, R., Wisplinghoff, H., and Jazmati, N. 2023. Comparison of AI-assisted and manual zone interpretation of Nitroxoline in uncomplicated urinary tract infections. 33^rd ECCMID. Copenhagen.