Medical Microbiology, Department of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK.
Bacteriology Reference Department, Public Health England, London, UK.
J Antimicrob Chemother. 2021 Apr 13;76(5):1113-1116. doi: 10.1093/jac/dkab027.
Legionella pneumophila, a Gram-negative bacillus, is the causative agent of Legionnaire's disease, a form of severe community-acquired pneumonia. Infection can have high morbidity, with a high proportion of patients requiring ICU admission, and up to 10% mortality, which is exacerbated by the lack of efficacy of typical empirical antibiotic therapy against Legionella spp. The fastidious nature of the entire Legionellaceae family historically required inclusion of activated charcoal in the solid medium to remove growth inhibitors, which inherently interferes with accurate antimicrobial susceptibility determination, an acknowledged methodological shortfall, now rectified by a new solid medium that gives results comparable to those of microbroth dilution. Here, as an international Legionella community (with authors representing various international reference laboratories, countries and clinical stakeholders for diagnosis and treatment of legionellosis), we set out recommendations for the standardization of antimicrobial susceptibility testing methods, guidelines and reference strains to facilitate an improved era of antibiotic resistance determination.
嗜肺军团菌，一种革兰氏阴性杆菌，是军团病的病原体，这是一种严重的社区获得性肺炎。感染可能有很高的发病率，很大比例的患者需要入住 ICU，死亡率高达 10%，这因针对军团菌属的典型经验性抗生素治疗效果不佳而加剧。整个军团菌科家族的苛刻性质在历史上需要在固体培养基中加入活性炭以去除生长抑制剂，这会不可避免地干扰准确的抗菌药物敏感性测定，这是公认的方法学缺陷，现在已通过一种新的固体培养基得到纠正，该培养基的结果与微量肉汤稀释法的结果相当。在这里，作为一个国际军团菌社区（作者代表了各种国际参考实验室、国家和临床利益相关者，用于军团病的诊断和治疗），我们提出了抗菌药物敏感性测试方法、指南和参考菌株的标准化建议，以促进抗生素耐药性测定的新时代。
