2012年临床和实验室标准协会（CLSI）修订标准后台湾地区非感染性疾病的耐药率。
Resistance rates of non- infections in Taiwan after the revision of 2012 Clinical and Laboratory Standards Institute breakpoints.
作者信息
Hii Ing-Moi, Liu Chun-Eng, Lee Yu-Lin, Liu Wei-Lun, Wu Ping-Feng, Hsieh Min-Han, Ho Mao-Wang, Chen Yen-Hsu, Wang Fu-Der
机构信息
Division of Infectious Disease, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
Department of Emergency and Critical Care Medicine, Fu Jen Catholic University Hospital, New Taipei City, Taiwan.
出版信息
Infect Drug Resist. 2019 Jan 15;12:235-240. doi: 10.2147/IDR.S184884. eCollection 2019.
PURPOSE
In 2012, the Clinical and Laboratory Standards Institute (CLSI) revised its breakpoints for drugs and species because of the increase in non- infections and their drug resistance. Following global trends, the non- candidemia resistance rate has increased in Taiwan as well. To update the antifungal susceptibility of non- candidemia isolates, we conducted a multicenter study using the revised break points.
PATIENTS AND METHODS
Patients with non- candidemia infections were identified at five tertiary hospitals in Taiwan from July 1, 2011, to June 30, 2014. The broth microdilution method using a Sensititre YeastOne system was performed for the determination of minimum inhibitory concentration (MIC). The susceptibility was interpreted based on the guidelines of the CLSI (CLSI M27-S4 and M27-S3).
RESULTS
was the predominant non- candidemia pathogen (42.4%), and it showed increased fluconazole non-susceptibility (36.3%) when compared to the results from previous studies. In particular, showed high cross-resistance to azole agents. isolates that were found to be resistant to fluconazole also showed increased resistance to voriconazole (82.2%) and posaconazole (100%). The increased non-susceptibility of to multiple antifungal agents, based on the revised break points, resulted from an increase in dose-dependent susceptibility (94.4%) rather than from an increase in resistance (5.6%).
CONCLUSION
The resistance rate of non- candidemia isolates is increasing, particularly for and .
目的
2012年，临床和实验室标准协会（CLSI）因非感染性疾病及其耐药性增加，修订了药物和菌种的折点。随着全球趋势，台湾地区非念珠菌血症的耐药率也有所上升。为更新非念珠菌血症分离株的抗真菌药敏情况，我们使用修订后的折点进行了一项多中心研究。
患者与方法
2011年7月1日至2014年6月30日期间，在台湾的五家三级医院中识别出非念珠菌血症感染患者。采用Sensititre YeastOne系统的肉汤微量稀释法测定最低抑菌浓度（MIC）。根据CLSI（CLSI M27-S4和M27-S3）指南解释药敏结果。
结果
是主要的非念珠菌血症病原体（42.4%），与以往研究结果相比，其对氟康唑的不敏感率有所增加（36.3%）。特别是，对唑类药物表现出高交叉耐药性。对氟康唑耐药的分离株对伏立康唑（82.2%）和泊沙康唑（100%）的耐药性也增加。根据修订后的折点，对多种抗真菌药物不敏感率增加是由于剂量依赖性药敏增加（94.4%）而非耐药性增加（5.6%）。
结论
非念珠菌血症分离株的耐药率在增加，尤其是对于和。
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