目的:类石病,是由假伯克霍尔德菌引起的,需要强化抗菌治疗。然而,基于现代原理的用于确定断点和确定方法性能的标准抗菌药物敏感性试验(AST)方法学对于假单胞菌缺乏。这项研究旨在建立MIC和区域直径分布,以使用标准EUCAST方法对非挑剔的生物设定假单胞菌的流行病学截止值(ECOFF)。
方法:非连续,通过肉汤微量稀释(BMD)和EUCAST圆盘扩散方法,在8个研究中心对8种抗菌药物的非重复临床假单胞菌分离株(每个中心9~70株)进行了试验.故意选择没有和具有可疑抗性机制的分离株。EUCAST开发实验室确保了研究材料的质量,并为测试性能和结果解释提供指导。根据EUCAST建议分析汇总结果以确定ECOFF。
结果:MIC和区域直径分布是使用对361个假单胞菌分离株获得的BMD和圆盘扩散结果生成的。测定阿莫西林-克拉维酸的MIC和区域直径ECOFFs(mg/L;mm)(8;22),头孢他啶(8;22),亚胺培南(2;29),美罗培南(2;26),多西环素(2;无),四环素(8;23),氯霉素(8;22)和甲氧苄啶-磺胺甲恶唑(4;28)。
结论:我们已经验证了标准BMD和椎间盘扩散方法学对假单胞菌AST的应用。本研究中产生的MIC和区域直径分布使我们能够为所研究的抗菌剂建立MIC和区域直径ECOFF。这些ECOFF用作EUCAST的背景数据,以设置假单胞菌的临床MIC和区域直径断点。
OBJECTIVE: Melioidosis, caused by Burkholderia pseudomallei, requires intensive antimicrobial treatment. However, standardized antimicrobial susceptibility testing (AST) methodology based on modern principles for determining breakpoints and ascertaining performance of methods are lacking for B. pseudomallei. This
study aimed to establish MIC and zone diameter distributions on which to set epidemiological cut-off (ECOFF) values for B. pseudomallei using standard EUCAST methodology for non-fastidious organisms.
METHODS: Non-consecutive, non-duplicate clinical B. pseudomallei isolates (9-70 per centre) were tested at eight
study centres against eight antimicrobials by broth microdilution (BMD) and the EUCAST disc diffusion method. Isolates without and with suspected resistance mechanisms were deliberately selected. The EUCAST Development Laboratory ensured the quality of
study materials, and provided guidance on performance of the tests and interpretation of results. Aggregated results were analysed according to EUCAST recommendations to determine ECOFFs.
RESULTS: MIC and zone diameter distributions were generated using BMD and disc diffusion results obtained for 361 B. pseudomallei isolates. MIC and zone diameter ECOFFs (mg/L; mm) were determined for amoxicillin-clavulanic acid (8; 22), ceftazidime (8; 22), imipenem (2; 29), meropenem (2; 26), doxycycline (2; none), tetracycline (8; 23), chloramphenicol (8; 22) and trimethoprim-sulfamethoxazole (4; 28).
CONCLUSIONS: We have validated the use of standard BMD and disc diffusion methodology for AST of B. pseudomallei. The MIC and zone diameter distributions generated in this
study allowed us to establish MIC and zone diameter ECOFFs for the antimicrobials studied. These ECOFFs served as background data for EUCAST to set clinical MIC and zone diameter breakpoints for B. pseudomallei.