دورية أكاديمية
Less Is More: When to Repeat Antimicrobial Susceptibility Testing.
| العنوان: | Less Is More: When to Repeat Antimicrobial Susceptibility Testing. |
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| المؤلفون: | Sarink MJ; Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands., Bode LGM; Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands., Croughs P; Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands., de Steenwinkel JEM; Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands., Verkaik NJ; Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands., van Westreenen M; Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands., Vogel M; Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands., Yusuf E; Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands. |
| المصدر: | Journal of clinical microbiology [J Clin Microbiol] 2023 Aug 23; Vol. 61 (8), pp. e0046323. Date of Electronic Publication: 2023 Jul 12. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Society for Microbiology Country of Publication: United States NLM ID: 7505564 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1098-660X (Electronic) Linking ISSN: 00951137 NLM ISO Abbreviation: J Clin Microbiol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Washington, American Society for Microbiology. |
| مواضيع طبية MeSH: | Escherichia coli* , Staphylococcus aureus*, Humans ; Drug Resistance, Bacterial ; Anti-Bacterial Agents/pharmacology ; Bacteria ; Pseudomonas aeruginosa ; Microbial Sensitivity Tests |
| مستخلص: | This study investigated the frequency of change of the antimicrobial susceptibility pattern when the same isolate was found in the same patient in various situations. We used laboratory data collected over a period of 8 years (January 2014 to December 2021) at the clinical microbiology laboratory of a tertiary hospital for Escherichia coli, Klebsiella pneumoniae, Enterobacter spp., Pseudomonas aeruginosa, and Staphylococcus aureus. Antimicrobial susceptibility tests (AST) were performed using Vitek 2 automated system. We determined essential agreement and categorical agreement, and introduced the new terms essential MIC increase and change from nonresistant to resistant to present changes in antimicrobial susceptibility over time. During the study period, 18,501 successive AST were included. The risk for S. aureus to be resistant to any antibiotic upon repeated culture was <10% during a follow-up of 30 days. For Enterobacterales, this risk was approximately 10% during a follow-up of 7 days. For P. aeruginosa, this risk was higher. The longer the follow-up period, the higher the risk that the bacteria would show phenotypic resistance. We also found that some drug-bug combinations were more likely to develop phenotypical resistance (i.e., E. coli/amoxicillin-clavulanic acid and E. coli/cefuroxime). A potential consequence of our finding is that if we regard a risk of resistance below 10% as acceptable, it may be feasible to omit follow-up AST within 7 days for the microorganisms investigated in this study. This approach saves money, time, and will reduce laboratory waste. Further studies are needed to determine whether these savings are in balance with the small possibility of treating patients with inadequate antibiotics. Competing Interests: The authors declare no conflict of interest. |
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| فهرسة مساهمة: | Keywords: VITEK; antimicrobial susceptibility testing; clinical microbiology laboratory; costs; laboratory management; phenotypic resistance |
| المشرفين على المادة: | 0 (Anti-Bacterial Agents) |
| تواريخ الأحداث: | Date Created: 20230712 Date Completed: 20230825 Latest Revision: 20240113 |
| رمز التحديث: | 20240113 |
| مُعرف محوري في PubMed: | PMC10446856 |
| DOI: | 10.1128/jcm.00463-23 |
| PMID: | 37436180 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1098-660X |
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| DOI: | 10.1128/jcm.00463-23 |