Assessment of the oxacillin disk screening test for determining penicillin resistance in Streptococcus pneumoniae

The I mu g oxacillin disk diffusion screening test was performed on 1516 recent clinical isolates of Streptococcus pneumoniae obtained in a 1994-1995 U.S. surveillance study and the results compared to penicillin MICs determined using a standardized broth microdilution method. The oxacillin disk screening method failed to distinguish penicillin-resistant strains from those that were intermediately susceptible. Furthermore, a high percentage (11.1%) of penicillin-susceptible strains, for which MICs of penicillin were usually 0.06 or 0.03 mu g/ml, yielded zone diameters of less than or equal to 19 mm with the oxacillin screen test and thus would have been falsely categorized as being resistant to penicillin.