Zoetis Global Therapeutics Research, Kalamazoo, MI, USA.
Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, KS, USA.
J Antimicrob Chemother. 2018 Jun 1;73(6):1460-1463. doi: 10.1093/jac/dky043.
Standardized definitions for MDR are currently not available in veterinary medicine despite numerous reports indicating that antimicrobial resistance may be increasing among clinically significant bacteria in livestock and companion animals. As such, assessments of MDR presented in veterinary scientific reports are inconsistent. Herein, we apply previously standardized definitions for MDR, XDR and pandrug resistance (PDR) used in human medicine to animal pathogens and veterinary antimicrobial agents in which MDR is defined as an isolate that is not susceptible to at least one agent in at least three antimicrobial classes, XDR is defined as an isolate that is not susceptible to at least one agent in all but one or two available classes and PDR is defined as an isolate that is not susceptible to all agents in all available classes. These definitions may be applied to antimicrobial agents used to treat bovine respiratory disease (BRD) caused by Mannheimia haemolytica, Pasteurella multocida and Histophilus somni and swine respiratory disease (SRD) caused by Actinobacillus pleuropneumoniae, P. multocida and Streptococcus suis, as well as antimicrobial agents used to treat canine skin and soft tissue infections (SSTIs) caused by Staphylococcus and Streptococcus species. Application of these definitions in veterinary medicine should be considered static, whereas the classification of a particular resistance phenotype as MDR, XDR or PDR could change over time as more veterinary-specific clinical breakpoints or antimicrobial classes and/or agents become available in the future.
尽管有大量报告表明,在牲畜和伴侣动物的临床重要细菌中,抗菌药物耐药性可能正在增加,但兽医医学中目前还没有针对 MDR 的标准化定义。因此,兽医科学报告中提出的 MDR 评估结果不一致。在此,我们将人类医学中先前标准化的 MDR、XDR 和泛耐药(PDR)定义应用于动物病原体和兽医抗菌药物,其中 MDR 定义为对至少三种抗菌药物类别中的一种药物不敏感的分离株,XDR 定义为对除一种或两种可用类别外的所有类别中的至少一种药物不敏感的分离株,PDR 定义为对所有可用类别中的所有药物均不敏感的分离株。这些定义可应用于治疗由溶血曼海姆菌、多杀巴斯德菌和溶血性巴斯德菌引起的牛呼吸道疾病 (BRD)、由胸膜肺炎放线杆菌、多杀巴斯德菌和猪链球菌引起的猪呼吸道疾病 (SRD),以及治疗由葡萄球菌和链球菌引起的犬皮肤和软组织感染 (SSTIs) 的抗菌药物。在兽医医学中应用这些定义应被视为静态的,而特定耐药表型被归类为 MDR、XDR 或 PDR 可能会随着未来更多兽医特定的临床折点或抗菌药物类别和/或药物的出现而发生变化。