关键词: Antimicrobial susceptibility testing Brazilian Committee on Antimicrobial Susceptibility Testing Clinical Laboratory Standards Institute Coagulase-negative staphylococci European Committee on Antimicrobial Susceptibility Testing Oxacillin resistance

Mesh : Adolescent Adult Aged Aged, 80 and over Anti-Bacterial Agents / pharmacology Bacterial Proteins / metabolism Brazil Child Coagulase / metabolism Drug Resistance, Bacterial Female Humans Male Microbial Sensitivity Tests / methods standards Middle Aged Outpatients Staphylococcal Infections / diagnosis microbiology Staphylococcus / drug effects enzymology genetics isolation & purification Young Adult

来  源:   DOI:10.1007/s42770-020-00278-1   PDF(Sci-hub)   PDF(Pubmed)

Abstract:
Coagulase-negative staphylococci (CoNS) are frequently isolated in clinical specimens and are important reservoirs of resistance genes. In 2019, the Brazilian government set the BrCAST/EUCAST (Brazilian Committee on Antimicrobial Susceptibility Testing) guidelines as the national standard, resulting in changes in the interpretation of CoNS susceptibility tests. From outpatients, disk-diffusion susceptibility of 65 CoNS cultures were evaluated and compared using classification criteria from both CLSI and BrCAST/EUCAST. The isolates were identified using matrix assisted laser desorption ionization-time of flight (MALDI-TOF), and the presence of the mecA gene was determined. The most prevalent species were Staphylococcus saprophyticus (32.3%), S. haemolyticus (18.5%), and S. epidermidis (9.2%). Almost perfect agreement was seen between the guidelines, except concerning oxacillin and gentamicin, and the prevalence of multidrug resistant isolates increased with the use of BrCAST/EUCAST. Of all, 15 (23.1%) isolates, mainly S. epidermidis and S. haemolyticus, were positive for the mecA gene, and only three were detected when using CLSI or BrCAST/EUCAST disk-diffusion screening. This, using either guideline, could reveal the difficulty of determining oxacillin resistance. Using warning zones or molecular methods might well be indicated for CoNS. In conclusion, adoption of the BrCAST/EUCAST guidelines will result in certain artificial changes in epidemiological susceptibility profiles, and clinicians and institutions should be aware of the possible implications.
摘要:
暂无翻译
公众号