Baquero F
Servicio de Microbiología, Hospital Ramón y Cajal, Madrid, Spain.
Eur J Clin Microbiol Infect Dis. 1990 Jul;9(7):492-5. doi: 10.1007/BF01964289.
Six different systems for antimicrobial susceptibility testing are used in Europe (BSAC, DIN, SFM, SIR, NCCLS and WRG). Breakpoints defining susceptibility or resistance of bacteria to antimicrobial agents remain the subject of discussion. Nevertheless, it is possible to establish a theoretical consensus standard list of breakpoints such that more than 95% of the breakpoints proposed by the different systems differ from the consensus standard by no more than one dilution. In general, the BSAC and DIN systems recommend lower breakpoints, and the SFM and NCCLS systems higher breakpoints than the consensus standard. Two-thirds of the discrepancies are related to the breakpoints defining susceptibility. The breakpoint for susceptibility should reflect the intrinsic susceptibility of the isolate (absence of mechanisms of resistance), and the breakpoint for resistance the pharmacological potential of the drug. The scientific validation of breakpoints requires clinical verification.
欧洲使用六种不同的抗菌药物敏感性测试系统（英国抗菌化疗协会、德国标准化学会、法国微生物学会、瑞典抗感染研究协会、美国国家临床实验室标准委员会和世界卫生组织参考小组）。界定细菌对抗菌药物敏感性或耐药性的断点仍是讨论的主题。然而，有可能建立一个理论上的共识标准断点列表，使得不同系统提出的断点中超过95%与共识标准的差异不超过一个稀释度。一般来说，英国抗菌化疗协会和德国标准化学会系统推荐的断点低于共识标准，而法国微生物学会和美国国家临床实验室标准委员会系统推荐的断点高于共识标准。三分之二的差异与界定敏感性的断点有关。敏感性断点应反映分离株的固有敏感性（不存在耐药机制），而耐药断点应反映药物的药理潜力。断点的科学验证需要临床验证。
