EUCAST evaluation of 21 brands of Mueller-Hinton dehydrated media for disk diffusion testing.

Mueller-Hinton (MH) agar is recommended by EUCAST and CLSI for disk diffusion antimicrobial susceptibility testing. Using EUCAST methodology, we evaluated the performance of 21 internationally available brands of dehydrated MH agar from 17 manufacturers.MH plates were prepared in-house and evaluated against four quality control (QC) strains tested in triplicate, using EUCAST disk diffusion methodology. This resulted in 30 disk-QC strain combinations and 90 readings per MH brand. All brands were tested blindly and in parallel. Results were evaluated against targets and ranges in the EUCAST QC tables. The agar depth, pH and concentration of five cations were measured for all brands.Six brands of MH agar (Bio-Rad, Biolife, Oxoid, Sigma MH 2, BD BBL MH II and CRITERION) demonstrated excellent performance, with ≥99% of zone diameter readings within QC ranges and ≥70% on target ±1 mm. The poorest performance was seen for Biolab and Merck MH, with 10% (9/90) and 23% (21/90) of readings outside the QC ranges, respectively. Of all readings, 4.9% (93/1890) were out-of-range, mainly related to trimethoprim-sulfamethoxazole (n=25), aminoglycosides (n=25) and fluoroquinolones (n=15). The cation content differed considerably between the agars and for four brands, pH were outside the acceptable range 7.2-7.4.This study evaluated the performance and content of 21 brands of MH dehydrated media. Six brands showed excellent performance with all investigated antimicrobial classes. Others exhibited problems with one or more classes of agents. This could partly be explained by differences in concentration of specific chemical components and pH.