未经证实:尿路感染是导致高发病率和死亡率的最常见细菌感染之一。全球范围内耐多药尿路病原体的惊人增长迫使临床医生重新考虑诸如福霉素之类的旧药物的治疗管理。我们的目的是比较琼脂稀释度,纸片扩散法和E-test法用于磷霉素对不同耐药尿路病原菌的药敏试验。
UNASSIGNED:使用琼脂稀释液连续测试了181种尿路病原体的磷霉素敏感性,圆盘扩散和E测试。使用临床和实验室标准研究所(CLSI)和欧洲抗菌药物敏感性测试委员会(EUCAST)断点来解释结果。对4株XDR/PDR磷霉素耐药肺炎克雷伯菌进行全基因组测序分析。
UNASSIGNED:发现大肠杆菌是最常见的尿路病原体(62.4%),其次是肺炎克雷伯菌(21%)。考虑到琼脂稀释为黄金标准,6.1%的菌株对磷霉素耐药。在CLSI断点之后,大肠杆菌的敏感性,肺炎克雷伯菌,其他肠杆菌和铜绿假单胞菌占92.9%,92.1%,100%,100%;而使用EUCAST断点的敏感性为85.7%,86.9%,92.9%,100%,分别。基本协议,绝对协议,主要错误,所有生物的电子测试/圆盘扩散的主要误差为91.2%/不适用,95%/93.9%,1.8%/4.7%,9.1%/9.1%,分别。全基因组测序显示突变UhpT基因以及质粒介导的fosA5或fosA6基因的存在赋予磷霉素抗性。
UNASSIGNED:该结果支持肠杆菌对磷霉素的耐药性非常低;因此,应被视为治疗多药耐药尿路病原体的有价值的选择。与琼脂稀释相比,观察到圆盘扩散是福霉素敏感性测试的便捷方法。
UNASSIGNED: Urinary tract infection is one of the most common bacterial infections causing high morbidity and mortality. The alarming rise of multidrug-resistant uropathogens worldwide forced the clinician to rethink the old drugs like Fosfomycin for its therapeutic management. Our objective was to compare agar dilution, disc diffusion and E-test method for antimicrobial susceptibility testing of Fosfomycin against different drug-resistant uropathogens.
UNASSIGNED: Consecutive 181 uropathogens were tested for Fosfomycin susceptibility using agar dilution, disc diffusion and E-test. Results were interpreted using Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints. Whole genome sequencing analysis was done on the 4 XDR/PDR Fosfomycin resistant Klebsiella pneumoniae isolates.
UNASSIGNED: Escherichia coli was found as the most common (62.4%) uropathogen followed by Klebsiella pneumoniae (21%). Considering agar dilution as the gold standard, 6.1% of isolates were resistant to Fosfomycin. Following CLSI breakpoints, the susceptibility of Escherichia coli, Klebsiella pneumoniae, other Enterobacterales and Pseudomonas aeruginosa were 92.9%, 92.1%, 100%, 100%; whereas using EUCAST breakpoints the susceptibility rates were 85.7%, 86.9%, 92.9%, and 100%, respectively. The essential agreement, categorical agreement, major error, and very major error for E-test/disc diffusion for all the organisms were 91.2%/Not Applicable, 95%/93.9%, 1.8%/4.7%, 9.1%/9.1%, respectively. Whole-genome sequencing showed mutation UhpT gene as well as the presence of plasmid-mediated fosA5 or fosA6 genes conferring Fosfomycin resistance.
UNASSIGNED: This result supports very low resistance of Enterobacterales against Fosfomycin; hence should be considered a valuable option to treat multidrug-resistant uropathogens. Disc diffusion was observed to be a convenient method for Fosfomycin susceptibility testing compared to agar dilution.