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In general, most laboratories have more stringent policies for repeat testing of organism than you have currently. For Gram-negative organisms known to exhibit frequent changes in the phenotypic expression of resistance mechanisms, for example Pseudomonas aeruginosa and other non-fermenters. Some people extend this to include the more commonly encountered extended-spectrum cephalosporin resistant enteric organisms such as Citrobacter, Enterobacter and Serratia. A typical protocol would be to repeat the susceptibility test on these organisms isolated from the same source on the same patient every 3-4 days. For all other organisms, our approach has always been to re-test if more than 7 days has elapsed since the last time the organism was isolated unless a test is specifically requested by a clinician (usually because of lack of clinical success with the initial antimicrobial regimen and the concern about 'emerging' resistance on therapy). A month between retests is far too long, particularly in the current climate of increasing isolation of resistant staphylococci and to a lesser extent enterococci, and is liable to encourage unnecessary adjunctive antimicrobial therapy (in the absence of data confirming the continued susceptibility of an organism) or further emergence of resistance if a susceptible organism has indeed been replaced by a more resistant strain during the testing interval.
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