Impact of CLSI and EUCAST Cefepime breakpoint changes on the susceptibility reporting for Enterobacteriaceae.

MedStar author(s):
Citation: Diagnostic Microbiology & Infectious Disease. 89(4):328-333, 2017 Dec.PMID: 29031525Institution: MedStar Washington Hospital CenterDepartment: Medicine/Infectious DiseasesForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Anti-Bacterial Agents/pd [Pharmacology] | *Bacterial Proteins/ge [Genetics] | *Cephalosporins/pd [Pharmacology] | *Enterobacteriaceae/ge [Genetics] | beta-Lactamases/ge [Genetics] | Ceftriaxone/pd [Pharmacology] | Drug Resistance, Multiple, Bacterial | Enterobacteriaceae Infections/di [Diagnosis] | Enterobacteriaceae Infections/dt [Drug Therapy] | Enterobacteriaceae/de [Drug Effects] | Escherichia coli/de [Drug Effects] | Humans | Klebsiella/de [Drug Effects] | Microbial Sensitivity Tests | Retrospective StudiesYear: 2017ISSN:
  • 0732-8893
Name of journal: Diagnostic microbiology and infectious diseaseAbstract: CONCLUSIONS: Lower cefepime MIC breakpoints decrease cefepime susceptibility for isolates harboring ESBLs, while sparing the majority of those with AmpCs.Copyright Published by Elsevier Inc.METHODS: Using Enterobacteriaceae susceptibility data from 2013 comparisons of MIC breakpoints were performed using Pearson's chi-squared test. Molecular testing on a subset of isolates was done.OBJECTIVE: We analyzed the effects of different cefepime MIC breakpoints on Enterobacteriaceae cefepime susceptibility and the presence of AmpC and extended-spectrum beta-lactamase (ESBL) genes within the cefepime MIC interpretative categories.RESULTS: Among 3784 non-duplicate clinical isolates, cefepime susceptibility decreased from 97.6% to 96.1% to 93.7% for CLSI 2013, CLSI 2014, and EUCAST 2011, respectively. In ceftriaxone non-susceptible isolates, cefepime susceptibility decreased from 79% to 66% (P<0.0001) using CLSI 2013 and 2014, respectively, which was greater and statistically significant for Escherichia coli and Klebsiella spp. but not for Enterobacter spp. (P=0.06). Isolates with MIC <=1mug/mL more often harbored AmpC (77%) than ESBL (18%) genes.All authors: Bork JT, Fowler RC, Hanson ND, Heil EL, Johnson JK, Leekha S, Majumdar AFiscal year: FY2018Digital Object Identifier: Date added to catalog: 2017-11-10
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Journal Article MedStar Authors Catalog Article 29031525 Available 29031525

CONCLUSIONS: Lower cefepime MIC breakpoints decrease cefepime susceptibility for isolates harboring ESBLs, while sparing the majority of those with AmpCs.

Copyright Published by Elsevier Inc.

METHODS: Using Enterobacteriaceae susceptibility data from 2013 comparisons of MIC breakpoints were performed using Pearson's chi-squared test. Molecular testing on a subset of isolates was done.

OBJECTIVE: We analyzed the effects of different cefepime MIC breakpoints on Enterobacteriaceae cefepime susceptibility and the presence of AmpC and extended-spectrum beta-lactamase (ESBL) genes within the cefepime MIC interpretative categories.

RESULTS: Among 3784 non-duplicate clinical isolates, cefepime susceptibility decreased from 97.6% to 96.1% to 93.7% for CLSI 2013, CLSI 2014, and EUCAST 2011, respectively. In ceftriaxone non-susceptible isolates, cefepime susceptibility decreased from 79% to 66% (P<0.0001) using CLSI 2013 and 2014, respectively, which was greater and statistically significant for Escherichia coli and Klebsiella spp. but not for Enterobacter spp. (P=0.06). Isolates with MIC <=1mug/mL more often harbored AmpC (77%) than ESBL (18%) genes.

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