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[拉丁美洲关于定义、分类和报告多重耐药、广泛耐药或全耐药病原体的共识 拉丁美洲关于定义、分类和报告多重耐药、广泛耐药或全耐药病原体的共识]

[Latin American consensus to define, categorize, and report multidrug-resistant, extensively drug-resistant, or pandrug-resistant pathogensConsenso latino-americano para definição, categorização e notificação de patógenos multirresistentes, com resistência ampliada ou panresistentes].

作者信息

Jiménez Pearson María Antonieta, Galas Marcelo, Corso Alejandra, Hormazábal Juan C, Duarte Valderrama Carolina, Salgado Marcano Nuris, Ramón-Pardo Pilar, Melano Roberto G

机构信息

Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA), Tres Ríos Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA), Tres Ríos Cartago Costa Rica Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA), Tres Ríos, Cartago, Costa Rica.

Organización Panamericana de la Salud Organización Panamericana de la Salud Washington, DC Estados Unidos de América Organización Panamericana de la Salud, Washington, DC, Estados Unidos de América.

出版信息

Rev Panam Salud Publica. 2019 Aug 22;43:e65. doi: 10.26633/RPSP.2019.65. eCollection 2019.

Abstract

This document presents a Latin American consensus to standardize definitions of different levels of antimicrobial resistance in bacteria of public health importance. Inclusion and exclusion criteria are described for antibiotics to include (availability, relevance, and existence of cut-off values) and for methodologies to use. Three gram-negative microorganisms with a great impact in the hospital environment (, and spp.) were selected as a pilot proposal. The lack of cut-off values for certain antibiotics (e.g., tigecycline, fosfomycin, and colistin), crucial in treating infections caused by multi-drug resistant or extensively drug-resistant pathogens, led to the need to discuss and agree on provisional cut-off values for monitoring resistance to these drugs. The work team also addressed and reached consensus on easier-to-use alternative susceptibility tests, other than methods approved by international guidelines, for routine testing in clinical bacteriology laboratories. The main benefit of this document is to provide Latin American laboratories with a standardized and consensual framework for the identification and constant and unified surveillance of resistant microorganisms. The recommendations included in this document are the result of consensus among representatives of the national reference laboratories in the countries belonging to the Latin American Surveillance Network of Antimicrobial Resistance, coordinated by the Pan American Health Organization.

摘要

本文档提出了一项拉丁美洲共识,旨在规范对具有公共卫生重要性的细菌中不同水平抗菌药物耐药性的定义。描述了纳入和排除标准,包括所纳入抗生素的标准(可用性、相关性和临界值的存在情况)以及所使用方法的标准。选择了三种在医院环境中有重大影响的革兰氏阴性微生物(、和属)作为试点提议。某些抗生素(如替加环素、磷霉素和黏菌素)缺乏临界值,而这些抗生素在治疗由多重耐药或广泛耐药病原体引起的感染中至关重要,这导致有必要就监测这些药物耐药性的临时临界值进行讨论并达成共识。工作团队还针对临床细菌学实验室常规检测中除国际指南批准方法之外的更易于使用的替代药敏试验进行了探讨并达成共识。本文档的主要益处在于为拉丁美洲实验室提供一个标准化且经各方认可的框架,用于鉴定以及持续统一监测耐药微生物。本文档中的建议是由泛美卫生组织协调的拉丁美洲抗菌药物耐药性监测网络所属国家的国家参考实验室代表之间达成共识的结果。

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