修订后的头孢吡肟CLSI折点对大肠埃希菌和肺炎克雷伯菌药敏的影响以及应用于铜绿假单胞菌时的潜在影响。
Impact of revised cefepime CLSI breakpoints on Escherichia coli and Klebsiella pneumoniae susceptibility and potential impact if applied to Pseudomonas aeruginosa.
作者信息
Hamada Yukihiro, Sutherland Christina A, Nicolau David P
机构信息
Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, Connecticut, USA Aichi Medical University Hospital School of Medicine, Aichi, Japan.
Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, Connecticut, USA.
出版信息
J Clin Microbiol. 2015 May;53(5):1712-4. doi: 10.1128/JCM.03652-14. Epub 2015 Feb 18.
The CLSI reduced the cefepime Enterobacteriaceae susceptibility breakpoint and introduced the susceptible-dose-dependent (S-DD) category. In this study, MICs were determined for a Gram-negative collection to assess the impact of this change. For Enterobacteriaceae, this resulted in <2% reduction in susceptibility, with 1% being S-DD. If applied to Pseudomonas aeruginosa, the % susceptibility (%S) dropped from 77% to 43%, with 34% being S-DD. The new breakpoints did little to the Enterobacteriaceae %S, but for P. aeruginosa, a profound reduction was seen in %S. The recognition of a S-DD response to cefepime should alert clinicians to the possible need for higher doses.
临床和实验室标准协会（CLSI）降低了头孢吡肟对肠杆菌科细菌的药敏折点，并引入了剂量依赖敏感（S-DD）类别。在本研究中，对一批革兰阴性菌进行了最低抑菌浓度（MIC）测定，以评估这一变化的影响。对于肠杆菌科细菌，这导致药敏率降低了不到2%，其中1%为S-DD。如果应用于铜绿假单胞菌，药敏率（%S）从77%降至43%，其中34%为S-DD。新的折点对肠杆菌科细菌的%S影响不大，但对铜绿假单胞菌而言，%S出现了显著下降。认识到对头孢吡肟的S-DD反应应提醒临床医生可能需要使用更高剂量。
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