Impact of CLSI and EUCAST Cefepime breakpoint changes on the susceptibility reporting for Enterobacteriaceae

被引：7

作者：

Bork, Jacqueline T. ^{[1
]}

Heil, Emily L. ^{[2
]}

Leekha, Surbhi ^{[1
,3
]}

Fowler, Randal C. ^{[4
]}

Hanson, Nancy D. ^{[5
]}

Majumdar, Anjali ^{[6
]}

Johnson, J. Kristie ^{[7
]}

机构：

[1] Univ Maryland, Sch Med, Dept Med, Div Infect Dis, Baltimore, MD 21201 USA

[2] Univ Maryland, Sch Med, Baltimore, MD 21201 USA

[3] Univ Maryland, Sch Med, Dept Publ Hlth & Epidemiol, Baltimore, MD 21201 USA

[4] Univ Nebraska Med Ctr, Dept Pathol & Microbiol, Omaha, NE USA

[5] Creighton Sch Med, Dept Microbiol & Immunol, Omaha, NE USA

[6] MedStar Washington Hosp Ctr, Div Infect Dis, Dept Med, Washington, DC USA

[7] Univ Maryland, Sch Med, Dept Pathol, Baltimore, MD 21201 USA

来源：

DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE | 2017年 / 89卷 / 04期

关键词：

Cefepime; Enterobacteriaceae; AmpC; ESBL; AMPC BETA-LACTAMASE; ESCHERICHIA-COLI; KLEBSIELLA-PNEUMONIAE; BACTEREMIA; THERAPY; GENES; CLOACAE; ESBL;

D O I：

10.1016/j.diagmicrobio.2017.08.020

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Objective: We analyzed the effects of different cefepime MIC breakpoints on Enterobacteriaceae cefepime susceptibility and the presence of AmpC and extended-spectrum beta-lactamase (ESBL) genes within the cefepime MIC interpretative categories. Methods: Using Enterobacteriaceae susceptibility data from 2013 comparisons of MIC breakpoints were performed using Pearson's chi-squared test. Molecular testing on a subset of isolates was done. Results: Among 3784 non-duplicate clinical isolates, cefepime susceptibility decreased from 97.6% to 96.1% to 93.7% for CLSI 2013, CLSI 2014, and EUCAST 2011, respectively. In ceftriaxone non-susceptible isolates, cefepime susceptibility decreased from 79% to 66% (P< 0.0001) using CLSI 2013 and 2014, respectively, which was greater and statistically significant for Escherichia coli and Klebsiella spp. but not for Enterobacter spp. (P = 0.06). Isolates with MIC <= 1 mu g/mL more often harbored AmpC (77%) than ESBL (18%) genes. Conclusions: Lower cefepime MIC breakpoints decrease cefepime susceptibility for isolates harboring ESBLs, while sparing the majority of those with AmpCs. Published by Elsevier Inc.

引用

页码：328 / 333

页数：6

共 27 条

[1] Ceftazidime-avibactam or best available therapy in patients with ceftazidime-resistant Enterobacteriaceae and Pseudomonas aeruginosa complicated urinary tract infections or complicated intra-abdominal infections (REPRISE): a randomised, pathogen-directed, phase 3 study [J].

Carmeli, Yehuda ;

Armstrong, Jon ;

Laud, Peter J. ;

Newell, Paul ;

Stone, Greg ;

Wardman, Angela ;

Gasink, Leanne B. .

LANCET INFECTIOUS DISEASES, 2016, 16 (06) :661-673

[2] Prevalence of β-Lactamase-Encoding Genes among Enterobacteriaceae Bacteremia Isolates Collected in 26 US Hospitals: Report from the SENTRY Antimicrobial Surveillance Program (2010) [J].

Castanheira, Mariana ;

Farrell, Sarah E. ;

Deshpande, Lalitagauri M. ;

Mendes, Rodrigo E. ;

Jones, Ronald N. .

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2013, 57 (07) :3012-3020

[3]

Ceyssens P, 2016, J ANTIMICROB CHEMOTH, P1

[4] Impact of Cefepime Therapy on Mortality among Patients with Bloodstream Infections Caused by Extended-Spectrum-β-Lactamase-Producing Klebsiella pneumoniae and Escherichia coli [J].

Chopra, Teena ;

Marchaim, Dror ;

Veltman, Jennifer ;

Johnson, Paul ;

Zhao, Jing J. ;

Tansek, Ryan ;

Hatahet, Dania ;

Chaudhry, Khawar ;

Pogue, Jason M. ;

Rahbar, Hiro ;

Chen, Ting-Yi ;

Thientu Truong ;

Rodriguez, Victor ;

Ellsworth, Joseph ;

Bernabela, Luigino ;

Bhargava, Ashish ;

Yousuf, Adnan ;

Alangaden, George ;

Kaye, Keith S. .

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2012, 56 (07) :3936-3942

[5]

Clinical and Laboratory Standards Institute (CLSI), 2014, PERF STAND ANT SUSC, V32

[6] Microbiological Screening Is Necessary to Distinguish Carriers of Plasmid-Mediated AmpC Beta-Lactamase-Producing Enterobacteriaceae and Extended-Spectrum Beta-Lactamase (ESBL)-Producing Enterobacteriaceae because of Clinical Similarity [J].

Conen, Anna ;

Frei, Reno ;

Adler, Hildegard ;

Dangel, Marc ;

Fux, Christoph A. ;

Widmer, Andreas F. .

PLOS ONE, 2015, 10 (03)

[7] Treatment options for extended-spectrum beta-lactamase (ESBL) and AmpC-producing bacteria [J].

D'Angelo, Ryan G. ;

Johnson, Jennifer K. ;

Bork, Jacqueline T. ;

Heil, Emily L. .

EXPERT OPINION ON PHARMACOTHERAPY, 2016, 17 (07) :953-967

[8] Recent advances in biochemical and molecular diagnostics for the rapid detection of antibiotic-resistant Enterobacteriaceae: a focus on ß-lactam resistance [J].

Decousser, Jean-Winoc ;

Poirel, Laurent ;

Nordmann, Patrice .

EXPERT REVIEW OF MOLECULAR DIAGNOSTICS, 2017, 17 (04) :327-350

[9]

European Committee on Antimicrobial Susceptibility Testing [EUCAST], 2015, BREAKP TABL INT MICS

[10] Rapid PCR amplification protocols decrease the turn-around time for detection of antibiotic resistance genes in Gram-negative pathogens [J].

Geyer, Chelsie N. ;

Hanson, Nancy D. .

DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE, 2013, 77 (02) :113-117

← 1 2 3 →