Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, CT 06102, USA.
Diagn Microbiol Infect Dis. 2012 Mar;72(3):258-62. doi: 10.1016/j.diagmicrobio.2011.11.011. Epub 2011 Dec 29.
Doripenem is not available on many automated susceptibility testing panels. We evaluated the surrogate predictive value (SPV) of meropenem and imipenem in predicting doripenem susceptibility using the different breakpoint definitions available globally. MIC data for 736 Pseudomonas aeruginosa were extracted, and categorical interpretations were performed using Clinical and Laboratory Standards Institute (CLSI) proposed 2012, European Committee on Antimicrobial Susceptibility Testing (EUCAST), and Food and Drug Administration (FDA) breakpoints. Regardless of the breakpoint applied, very major and major errors were observed in only 0.1-0.8% and 0.1-4.5% of isolates, respectively. Meropenem's SPV was 98.6% for CLSI 2012 breakpoints, 94.0% for EUCAST, and 95.0% for FDA. Imipenem's SPV was 98.6%, 90.9%, and 97.2%, respectively. These data indicate that meropenem and imipenem would be reliable surrogate markers of doripenem susceptibility when using CLSI 2012 and FDA breakpoints. Meropenem would be recommended over imipenem for EUCAST breakpoints. However, meropenem and imipenem nonsusceptible isolates should be directly tested against doripenem since the latter antibiotic may still retain susceptibility against these isolates.
多利培南在许多自动化药敏检测板上不可用。我们评估了美罗培南和亚胺培南在使用全球不同折点定义预测多利培南药敏时的替代预测值（SPV）。提取了 736 株铜绿假单胞菌的 MIC 数据，并使用临床和实验室标准协会（CLSI）2012 年提出的、欧洲抗菌药物敏感性试验委员会（EUCAST）和美国食品和药物管理局（FDA）的折点进行了分类解释。无论应用何种折点，仅有 0.1-0.8%和 0.1-4.5%的分离株分别出现了非常大的和主要错误。美罗培南对 CLSI 2012 折点的 SPV 为 98.6%，对 EUCAST 的 SPV 为 94.0%，对 FDA 的 SPV 为 95.0%。亚胺培南的 SPV 分别为 98.6%、90.9%和 97.2%。这些数据表明，当使用 CLSI 2012 和 FDA 折点时，美罗培南和亚胺培南将是多利培南药敏的可靠替代标志物。对于 EUCAST 折点，建议使用美罗培南而不是亚胺培南。然而，对于美罗培南和亚胺培南不敏感的分离株，应直接对其进行多利培南测试，因为后者的抗生素可能仍对这些分离株保持敏感性。
