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Kirby-Bauer antibiotic testing (KB testing or disc diffusion antibiotic sensitivity testing) is a test which uses antibiotic-impregnated wafers to test whether bacteria are affected by antibiotics. In this test, wafers containing antibiotics are placed on an agar plate where bacteria have been placed, and the plate is left to incubate. If an antibiotic stops the bacteria from growing or kills the bacteria, there will be an area around the wafer where the bacteria have not grown enough to be visible. This is called a zone of inhibition.
The size of this zone depends on how effective the antibiotic is at stopping the growth of the bacterium. A stronger antibiotic will create a larger zone, because a lower concentration of the antibiotic is enough to stop growth.
The bacteria in question is swabbed uniformly across a culture plate. A filter-paper disk, impregnated with the compound to be tested, is then placed on the surface of the agar. The compound diffuses from the filter paper into the agar. The concentration of the compound will be highest next to the disk, and will decrease as distance from the disk increases. If the compound is effective against bacteria at a certain concentration, no colonies will grow where the concentration in the agar is greater than or equal to the effective concentration. This is the zone of inhibition. This along with the rate of antibiotic diffusion are used to estimate the bacteria's sensitivity to that particular antibiotic. In general, larger zones correlate with smaller minimum inhibitory concentration (MIC) of antibiotic for that bacteria. Inhibition produced by the test is compared with that produced by known concentration of a reference compound. This information can be used to choose appropriate antibiotics to combat a particular infection.
All aspects of the Kirby-Bauer procedure are standardized to ensure consistent and accurate results. Because of this, a laboratory must adhere to these standards. The media used in Kirby-Bauer testing must be Mueller-Hinton agar at only 4 mm deep, poured into either 100m or 150mm Petri dishes. The pH level of the agar must be between 7.2 and 7.4.