Division of Microbiology, Universidade Estadual de Ponta Grossa do Paraná, Ponta Grossa, Paraná, Brazil.
Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil.
J Clin Microbiol. 2021 Nov 18;59(12):e0153621. doi: 10.1128/JCM.01536-21. Epub 2021 Sep 29.
We evaluated the performance of ceftazidime-avibactam and ceftolozane-tazobactam MicroScan Neg multidrug-resistant MIC 1 (NMR1) panel for clinical carbapenem-nonsusceptible Gram-negative bacilli isolates. We evaluated 212 clinically significant carbapenem-nonsusceptible Gram-negative bacilli (139 Pseudomonas aeruginosa and 73 KPC-producing ) from 71 Brazilian hospitals (2013 to 2020). Ceftazidime-avibactam and ceftolozane-tazobactam MICs from the panel were compared with a broth microdilution (BMD) test as the reference method. Essential agreement (EA) and categorical agreement (CA) were assessed. For P. aeruginosa, antimicrobial susceptibility testing error rates were calculated using the error-rate bound method. Discrepancies were initially observed with 11 isolates; 4 resolved after retesting, 2 in favor of the NMR1 and 2 in favor of the BMD method. The ceftazidime-avibactam EA (overall and evaluable) was 100% for P. aeruginosa and The CA was 100% for and 98.6% for P. aeruginosa. The ceftolozane-tazobactam EA was 98.6% and 100% (overall and evaluable, respectively), and the CA was 96.4% for P. aeruginosa. For ceftazidime/avibactam, no very major error (VME) was found, and the major error (ME) rate was 4.2% (2/48). For ceftolozane-tazobactam and P. aeruginosa, using the CLSI breakpoints, the minor error (mE) was 11.4%, and no VME or ME was found. While using EUCAST breakpoints, the VME was 11.4% with no ME. The mE becomes ME or VME in the absence of the intermediate category. All categorical errors were also within 1 log of MIC variation, and the adjusted error rate for CLSI/EUCAST was 0% (0/212). The NMR1 panel is an option to test ceftazidime-avibactam for KPC-producing and carbapenem-nonsusceptible P. aeruginosa. When a MIC of 4 mg/liter for ceftolozane-tazobactam is obtained using this method, an alert could be created, and the results could be confirmed by an alternative method.
我们评估了 ceftazidime-avibactam 和 ceftolozane-tazobactam MicroScan Neg multidrug-resistant MIC 1 (NMR1) 面板用于临床碳青霉烯类药物不敏感革兰氏阴性杆菌分离株的性能。我们评估了来自 71 家巴西医院（2013 年至 2020 年）的 212 株临床意义重大的碳青霉烯类药物不敏感革兰氏阴性杆菌（139 株铜绿假单胞菌和 73 株产 KPC）。ceftazidime-avibactam 和 ceftolozane-tazobactam 的 MIC 来自面板与肉汤微量稀释（BMD）测试作为参考方法进行比较。评估了基本一致性（EA）和分类一致性（CA）。对于铜绿假单胞菌，使用误差率边界法计算抗菌药物敏感性测试误差率。最初观察到 11 个分离物存在差异；4 个经重新测试后解决，2 个有利于 NMR1，2 个有利于 BMD 方法。ceftazidime-avibactam 的 EA（总体和可评估）为 100%，CA 为 100%。对于产 KPC 的铜绿假单胞菌和碳青霉烯类药物不敏感铜绿假单胞菌，ceftolozane-tazobactam 的 EA 为 98.6%，CA 为 96.4%。对于 ceftazidime/avibactam，未发现非常大的错误（VME），主要错误（ME）率为 4.2%（2/48）。对于 ceftolozane-tazobactam 和铜绿假单胞菌，使用 CLSI 折点，小错误（mE）为 11.4%，未发现 VME 或 ME。使用 EUCAST 折点时，VME 为 11.4%，无 ME。在没有中间类别的情况下，mE 变为 ME 或 VME。所有分类错误都在 MIC 变化的 1 个对数范围内，CLSI/EUCAST 的调整错误率为 0%（0/212）。NMR1 面板是测试产 KPC 的铜绿假单胞菌和碳青霉烯类药物不敏感铜绿假单胞菌的 ceftazidime-avibactam 的一种选择。当使用该方法获得 ceftolozane-tazobactam 的 4 毫克/升 MIC 时，可以创建警报，并通过替代方法确认结果。
