Abstract：
Recently, considerable uncertainty has arisen concerning the appropriate susceptibility testing for cefiderocol in gram-negative bacilli, particularly in the context of its application to Acinetobacter spp. The optimal method for assessing the susceptibility levels of Acinetobacter spp. to cefiderocol remains a subject of debate due to substantial disparities observed in the values obtained through various testing procedures. This study employed four minimum inhibitory concentration (MIC) methodologies and the disk diffusion to assess the susceptibility of twenty-seven carbapenem resistant (CR)-Acinetobacter strains to cefiderocol. The results from our study reveal significant variations in the minimum inhibitory concentration (MIC) values obtained with the different methods and in the level of agreement in interpretation categories between the different MIC methods and the disk diffusion test. Among the MIC methods, there was relatively more consistency in reporting the interpretation categories. For European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints, the categorical agreement (CA) for MIC methods ranged between 66.7 and 81.5%. On the other hand, the essential agreement (EA) values were as low as 18.5-29.6%. The CA between MIC methods and disk diffusion was 81.5%. These results emphasize the need for a reliable, accurate, and clinically validated methodology to effectively assess the susceptibility of Acinetobacter spp. to cefiderocol. The wide variability observed in our study highlights the importance of standardizing the susceptibility testing process for cefiderocol to ensure consistent and reliable results for clinical decision-making.
摘要：
最近,关于革兰阴性杆菌中头孢地洛的适当药敏试验，已经出现了相当大的不确定性，特别是在其应用于不动杆菌属的情况下。评估不动杆菌敏感性水平的最佳方法。由于在通过各种测试程序获得的值中观察到的巨大差异，头孢地洛仍然是一个争论的话题。这项研究采用了四种最低抑制浓度（MIC）方法和圆盘扩散来评估二十七种碳青霉烯耐药（CR）-不动杆菌菌株对头孢地洛的敏感性。我们的研究结果表明，使用不同方法获得的最小抑制浓度（MIC）值以及不同MIC方法与圆盘扩散测试之间解释类别的一致性水平存在显着差异。在MIC方法中，报告解释类别的一致性相对较高.对于欧洲抗菌药物敏感性测试委员会（EUCAST）断点，MIC方法的分类一致性(CA)在66.7%至81.5%之间.另一方面,基本一致性（EA）值低至18.5-29.6%。MIC方法和圆盘扩散之间的CA为81.5%。这些结果强调了对可靠，准确,和临床验证的方法，以有效评估不动杆菌属的敏感性。去塞菲德罗.在我们的研究中观察到的广泛变异性突出了标准化头孢地洛的敏感性测试过程以确保临床决策的一致和可靠结果的重要性。
