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MIC in microbiology: how the number is actually measured

Broth microdilution, agar dilution and gradient strips give different answers for good reasons. Here is what happens on the bench, and where the error comes from.

21 July 2026 8 min read Method

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Sample output Ciprofloxacin Fluoroquinolone
Worked example, replaced when you run
Strain MIC (µg/mL) Call Resistance risk Conf.
S. aureus (MRSA) 0.5->32 R Resistant target mutation, grlA and gyrA Fluoroquinolone resistance is widespread in methicillin resistant lineages.
E. coli <=0.015-0.06 S Susceptible efflux, AcrAB-TolC in resistant isolates Potent against wild type; qnr carriage and gyrA changes shift the band sharply.
K. pneumoniae (CRE) 0.5->64 R Resistant gyrA mutation with plasmid qnr Carbapenemase producing isolates almost always carry quinolone resistance too.
A. baumannii 8->64 R Resistant efflux, AdeABC Constitutive efflux plus target changes leave little room at achievable exposure.
P. aeruginosa 0.25-2 I Intermediate efflux, MexAB-OprM Borderline: active on many isolates, lost quickly once efflux is derepressed.
E. faecium (VRE) 4->32 R Resistant target mutation, parC Enterococci are intrinsically poor fluoroquinolone targets.

Why

Ciprofloxacin is a well characterised fluoroquinolone, so the Gram-negative bands are strongly supported by published activity data. The deciding factor across this panel is not target affinity but exposure: efflux in P. aeruginosa and A. baumannii, and acquired target mutation everywhere resistance is already common. Against a modern ESKAPE panel it reads as a Gram-negative agent with two reliable losses.

Closest published analogs

  • Levofloxacin Broadly similar Gram-negative bands, better Gram-positive coverage
  • Delafloxacin Retains activity against many ciprofloxacin resistant staphylococci
Strain MIC (µg/mL) Call Resistance risk Conf.

Why

Closest published analogs

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Computational prediction from published literature. Research use only, not a lab measurement and not clinical guidance.

Four methods are in routine use, they give related but not identical answers, and knowing which produced a number changes how much weight it deserves. Here is what happens on the bench.

Broth microdilution, the reference method

A 96 well plate, a doubling dilution series across the rows, a standardised inoculum in every well, and a read after overnight incubation. The steps that matter:

  1. Medium. Cation adjusted Mueller Hinton broth. The cation adjustment is not a detail: divalent cation concentration materially changes aminoglycoside and polymyxin results.
  2. Inoculum. Approximately 5 x 105 colony forming units per millilitre in the final well. Prepared from a fresh culture adjusted to a 0.5 McFarland standard and then diluted.
  3. Compound. Dissolved, usually in DMSO, then diluted so that the solvent concentration is low enough not to inhibit growth by itself. Solvent controls exist for exactly this reason.
  4. Incubation. 35 to 37 degrees Celsius, ambient air, 16 to 20 hours.
  5. Reading. By eye against a dark background, or by optical density, or with a metabolic indicator such as resazurin where visual reads are unreliable.
  6. Controls. Growth control, sterility control and a quality control strain with a published expected range. If the QC strain is out of range, the plate is void, not interesting.

Agar dilution

Compound is incorporated into molten agar at each concentration, plates are poured, and organisms are spotted on top with a replicator. Laborious to set up and excellent when you want many organisms against a few concentrations, which makes it the traditional choice for surveillance work and for organisms that grow poorly in broth.

Gradient diffusion strips

A plastic strip carrying an exponential concentration gradient is laid on an inoculated agar plate. An elliptical zone of inhibition forms and the MIC is read where the ellipse meets the strip. Fast, convenient, and able to report values between doubling steps, which reads as extra precision but is really a different scale. Agreement with broth microdilution is usually within one doubling dilution, which is the same tolerance applied everywhere else.

Disk diffusion is not a MIC

A paper disk with a fixed compound load, a zone diameter in millimetres, and a species specific interpretive table. It is a susceptibility test, and a good one, but the output is a category rather than a concentration. Converting a zone diameter into a MIC is not valid without a validated regression for that agent and organism.

Where the error comes from

SourceEffectControl
Inoculum sizeToo heavy shifts MICs up, the inoculum effect, pronounced for beta-lactamsColony count the prepared inoculum periodically
Medium compositionCations, thymidine, serum content all shift specific classesUse the standard medium, state deviations
Compound solubilityPrecipitation in the top wells reads as activity lossInspect wells, check solvent limits
Plate bindingCationic peptides adsorb to polystyreneTreated plates, or state the plate type
Reading timeEarly reads flatter the compoundFixed window, same reader
SubjectivityTrailing endpoints are read differently by different peopleDefined endpoint criteria, or an indicator dye

The last row is the one that surprises people new to the assay. A trailing endpoint, where growth fades gradually across several wells rather than stopping cleanly, is common with bacteriostatic agents, and the convention for reading it has to be agreed within the group or the numbers will not be comparable between two people at the same bench.

What this means when you read a published number

Keep the method with the number. A MIC from a gradient strip, a MIC from broth microdilution in standard medium and a MIC from a screening assay in a non standard buffer are three different quantities that share a unit. This is the main reason assembling a picture from public bioactivity data takes an afternoon per compound.

And when you read a predicted number

A prediction is standing on the same heterogeneous literature, so it inherits the same uncertainty and should say so. That is why every predicted row carries a confidence level, and why a compound with no published neighbourhood gets no band rather than a plausible one. The MIC reference page covers the definition and interpretation side, and the method page explains how the confidence level is assigned.

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