MMWR Morb Mortal Wkly Rep. 2004 Feb 27;53(7):152-4.
In January 2003, the National Committee for Clinical Laboratory Standards (NCCLS) finalized new breakpoints for defining the susceptibility of Streptococcus pneumoniae isolates to cefotaxime and ceftriaxone. The former breakpoints were based on attainable concentrations of these antibiotics in cerebrospinal fluid (CSF) and the level at which it was thought that meningitis treatment failed because of elevated minimum inhibitory concentrations (MICs). The new breakpoints differ for S. pneumoniae isolates causing meningitis and those causing nonmeningeal clinical syndromes. To assess the effect of these new criteria on reporting of nonsusceptible S. pneumoniae isolates, CDC analyzed cefotaxime MIC data from the Active Bacterial Core Surveillance (ABCs) of the Emerging Infections Program (EIP) Network during 1998-2001. This report summarizes the results of that analysis, which indicated that after the new criteria were applied, the number of isolates defined as nonsusceptible to cefotaxime decreased 52.1%-61.2% for each year. Laboratory reports for clinicians should include interpretations using the new breakpoints for meningitis and nonmeningeal syndromes for all non-CSF isolates.
2003年1月，美国国家临床实验室标准委员会（NCCLS）最终确定了新的折点，用于界定肺炎链球菌分离株对头孢噻肟和头孢曲松的敏感性。以前的折点是基于这些抗生素在脑脊液（CSF）中可达到的浓度以及因最低抑菌浓度（MIC）升高而被认为脑膜炎治疗失败的水平。对于引起脑膜炎的肺炎链球菌分离株和引起非脑膜临床综合征的分离株，新的折点有所不同。为评估这些新标准对报告非敏感肺炎链球菌分离株的影响，美国疾病控制与预防中心（CDC）分析了1998 - 2001年期间新兴传染病项目（EIP）网络的活性细菌核心监测（ABCs）中的头孢噻肟MIC数据。本报告总结了该分析结果，结果表明应用新标准后，每年被界定为对头孢噻肟不敏感的分离株数量减少了52.1% - 61.2%。临床医生的实验室报告应包括针对所有非脑脊液分离株，使用针对脑膜炎和非脑膜综合征的新折点进行的解读。
