Servicio de Microbiología, Hospital Universtario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain.
Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Microbiología, Hospital Universitario Son Espases, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma de Mallorca, Spain.
Enferm Infecc Microbiol Clin (Engl Ed). 2020 Apr;38(4):182-187. doi: 10.1016/j.eimc.2019.01.017. Epub 2019 Mar 14.
Automated antimicrobial susceptibility testing devices are widely implemented in clinical microbiology laboratories in Spain, mainly using EUCAST (European Committee on Antimicrobial Susceptibility Testing) breakpoints. In 2007, a group of experts published recommendations for including antimicrobial agents and selecting concentrations in these systems. Under the patronage of the Spanish Antibiogram Committee (Comité Español del Antibiograma, COESANT) and the Study Group on Mechanisms of Action and Resistance to Antimicrobial Agents (GEMARA) from the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), and aligned with the Spanish National Plan against Antimicrobial Resistance (PRAN), a group of experts have updated this document. The main modifications from the previous version comprise the inclusion of new antimicrobial agents, adaptation of the ranges of concentrations to cover the EUCAST breakpoints and epidemiological cut-off values (ECOFFs), and the inference of new resistance mechanisms. This proposal should be considered by different manufacturers and users when designing new panels or cards. In addition, recommendations for selective reporting are also included. With this approach, the implementation of EUCAST breakpoints will be easier, increasing the quality of antimicrobial susceptibility testing data and their microbiological interpretation. It will also benefit epidemiological surveillance studies as well as the clinical use of antimicrobials aligned with antimicrobial stewardship programs.
西班牙临床微生物学实验室广泛使用欧盟药敏试验委员会（EUCAST）折点来实施自动化抗菌药物敏感性检测设备。早在 2007 年，一组专家就发表了相关建议，包括在这些系统中添加抗菌药物并选择浓度。在西班牙抗生素耐药性监测计划（PRAN）的支持下，西班牙传染病和临床微生物学学会（SEIMC）的抗生素耐药性监测委员会（Comité Español del Antibiograma，COESANT）和抗菌药物作用机制和耐药性研究小组（GEMARA）的专家们更新了这份文件。与上一版本相比，主要的修改包括纳入新的抗菌药物、调整浓度范围以涵盖 EUCAST 折点和流行病学临界点（ECOFFs）以及推断新的耐药机制。不同的制造商和用户在设计新的药敏检测板或卡片时应考虑这一建议。此外，还包括了选择性报告的建议。采用这种方法，实施 EUCAST 折点将变得更加容易，提高抗菌药物敏感性检测数据的质量及其微生物学解释。这也有利于流行病学监测研究以及与抗菌药物管理计划相一致的抗菌药物的临床应用。
