建立临床与实验室标准协会M45铜绿假单胞菌以外假单胞菌的药敏试验方法及断点。

IF 5.4 2区 医学 Q1 MICROBIOLOGY
Journal of Clinical Microbiology Pub Date : 2025-08-13 Epub Date: 2025-06-30 DOI:10.1128/jcm.00368-25
Patricia J Simner, Harley Harris, Emily Jacobs, Haley Stambaugh, Amira Bhalodi, Mark Fisher, Tsigereda Tekle, Jennifer Lu, Romney Humphries
{"title":"建立临床与实验室标准协会M45铜绿假单胞菌以外假单胞菌的药敏试验方法及断点。","authors":"Patricia J Simner, Harley Harris, Emily Jacobs, Haley Stambaugh, Amira Bhalodi, Mark Fisher, Tsigereda Tekle, Jennifer Lu, Romney Humphries","doi":"10.1128/jcm.00368-25","DOIUrl":null,"url":null,"abstract":"<p><p>The purpose of this study was to establish tentative Clinical and Laboratory Standards Institute (CLSI) M45 MIC and disk diffusion (DD) breakpoints (BPs) for <i>Pseudomonas</i> other than <i>Pseudomonas aeruginosa</i> (POPA). Mechanisms of antimicrobial resistance (AMR) and the modified carbapenem inactivation method (mCIM) to detect carbapenemase production were also evaluated. MIC data from <i>P. aeruginosa</i> and POPA from 2013 to 2022 were evaluated to compare the MIC distributions and modal MICs relative to the CLSI M100 <i>P. aeruginosa</i> BPs. A disk-to-MIC correlation study with 83 isolates was completed by testing reference broth microdilution and DD from the same inoculum, and the error-rate bounded method was used to establish DD BPs. For most antimicrobials, the modal MICs between <i>P. aeruginosa</i> and POPA were within 1-doubling dilution and lower than the M100 <i>P. aeruginosa-</i>susceptible BP. For amikacin, the modal MIC for POPA was 2-doubling dilutions lower than <i>P. aeruginosa</i> and was evaluated relative to the Enterobacterales BP. For aztreonam and trimethoprim-sulfamethoxazole, the modal MICs were elevated, and no BPs were set. New DD correlates were established for most antimicrobial agents, except for fluoroquinolones, where the <i>P. aeruginosa</i> correlates were suitable. AMR genes conferring resistance to multiple antimicrobial classes were identified by WGS. Beta-lactamase genes were identified in 30 (36.1%) isolates, with metallo-beta-lactamases (90.6%) predominating. The mCIM had a sensitivity and specificity of 100%. Upon review, the CLSI M45 committee proposed tentative MIC and DD BPs for expanded-spectrum cephalosporins (ceftazidime and cefepime), carbapenems (meropenem and imipenem), fluoroquinolones (ciprofloxacin and levofloxacin), and the aminoglycosides (amikacin and tobramycin).<b>IMPORTANCE</b><i>Pseudomonas</i> species other than <i>Pseudomonas aeruginosa</i> (POPA) can cause opportunistic infections which may be difficult to treat due to a variety of antimicrobial resistance mechanisms. Antimicrobial susceptibility testing is a critical component of patient management for these infections. Currently, the Clinical and Laboratory Standards Institute (CLSI) M100 non-Enterobacterales breakpoints and methodology are utilized for POPA by US clinical laboratories and likely do not accurately predict susceptibility results. The purpose of this study was to establish tentative CLSI M45 MIC and disk diffusion breakpoints for POPA. Mechanisms of antimicrobial resistance and the modified carbapenem inactivation method to detect carbapenemase production were also evaluated. We present the data used by the volunteers tasked by CLSI to develop POPA breakpoints in the M45 guidelines.</p>","PeriodicalId":15511,"journal":{"name":"Journal of Clinical Microbiology","volume":" ","pages":"e0036825"},"PeriodicalIF":5.4000,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12345185/pdf/","citationCount":"0","resultStr":"{\"title\":\"Establishing Clinical and Laboratory Standards Institute M45 antimicrobial susceptibility testing methods and breakpoints for <i>Pseudomonas</i> other than <i>Pseudomonas aeruginosa</i>.\",\"authors\":\"Patricia J Simner, Harley Harris, Emily Jacobs, Haley Stambaugh, Amira Bhalodi, Mark Fisher, Tsigereda Tekle, Jennifer Lu, Romney Humphries\",\"doi\":\"10.1128/jcm.00368-25\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The purpose of this study was to establish tentative Clinical and Laboratory Standards Institute (CLSI) M45 MIC and disk diffusion (DD) breakpoints (BPs) for <i>Pseudomonas</i> other than <i>Pseudomonas aeruginosa</i> (POPA). Mechanisms of antimicrobial resistance (AMR) and the modified carbapenem inactivation method (mCIM) to detect carbapenemase production were also evaluated. MIC data from <i>P. aeruginosa</i> and POPA from 2013 to 2022 were evaluated to compare the MIC distributions and modal MICs relative to the CLSI M100 <i>P. aeruginosa</i> BPs. A disk-to-MIC correlation study with 83 isolates was completed by testing reference broth microdilution and DD from the same inoculum, and the error-rate bounded method was used to establish DD BPs. For most antimicrobials, the modal MICs between <i>P. aeruginosa</i> and POPA were within 1-doubling dilution and lower than the M100 <i>P. aeruginosa-</i>susceptible BP. For amikacin, the modal MIC for POPA was 2-doubling dilutions lower than <i>P. aeruginosa</i> and was evaluated relative to the Enterobacterales BP. For aztreonam and trimethoprim-sulfamethoxazole, the modal MICs were elevated, and no BPs were set. New DD correlates were established for most antimicrobial agents, except for fluoroquinolones, where the <i>P. aeruginosa</i> correlates were suitable. AMR genes conferring resistance to multiple antimicrobial classes were identified by WGS. Beta-lactamase genes were identified in 30 (36.1%) isolates, with metallo-beta-lactamases (90.6%) predominating. The mCIM had a sensitivity and specificity of 100%. Upon review, the CLSI M45 committee proposed tentative MIC and DD BPs for expanded-spectrum cephalosporins (ceftazidime and cefepime), carbapenems (meropenem and imipenem), fluoroquinolones (ciprofloxacin and levofloxacin), and the aminoglycosides (amikacin and tobramycin).<b>IMPORTANCE</b><i>Pseudomonas</i> species other than <i>Pseudomonas aeruginosa</i> (POPA) can cause opportunistic infections which may be difficult to treat due to a variety of antimicrobial resistance mechanisms. Antimicrobial susceptibility testing is a critical component of patient management for these infections. Currently, the Clinical and Laboratory Standards Institute (CLSI) M100 non-Enterobacterales breakpoints and methodology are utilized for POPA by US clinical laboratories and likely do not accurately predict susceptibility results. The purpose of this study was to establish tentative CLSI M45 MIC and disk diffusion breakpoints for POPA. Mechanisms of antimicrobial resistance and the modified carbapenem inactivation method to detect carbapenemase production were also evaluated. We present the data used by the volunteers tasked by CLSI to develop POPA breakpoints in the M45 guidelines.</p>\",\"PeriodicalId\":15511,\"journal\":{\"name\":\"Journal of Clinical Microbiology\",\"volume\":\" \",\"pages\":\"e0036825\"},\"PeriodicalIF\":5.4000,\"publicationDate\":\"2025-08-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12345185/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Microbiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1128/jcm.00368-25\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/30 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"MICROBIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Microbiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1128/jcm.00368-25","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/30 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"MICROBIOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

本研究的目的是为铜绿假单胞菌(POPA)以外的假单胞菌建立初步的临床和实验室标准协会(CLSI) M45 MIC和磁盘扩散(DD)断点(bp)。并对其耐药机制(AMR)和检测碳青霉烯酶生成的改良碳青霉烯酶失活法(mCIM)进行了评价。对2013年至2022年铜绿假单胞菌和POPA的MIC数据进行评估,比较与CLSI M100铜绿假单胞菌bp相关的MIC分布和模态MIC。通过对83株分离菌株进行相同接种量的参考肉汤微量稀释和DD的盘中- mic相关性研究,并采用错误率有界法建立DD bp。对于大多数抗菌素,铜绿假单胞菌和POPA之间的模态mic在1倍稀释范围内,低于铜绿假单胞菌敏感BP的M100。对于阿米卡星,POPA的模态MIC比铜绿假单胞菌低2倍,并相对于肠杆菌BP进行了评估。对于氨曲南和甲氧苄啶磺胺甲恶唑,模态mic升高,未设置bp。除氟喹诺酮类药物适用铜绿假单胞菌相关物外,大多数抗菌药物都建立了新的DD相关物。通过WGS鉴定出对多种抗菌素具有耐药性的AMR基因。30株(36.1%)分离到β -内酰胺酶基因,其中以金属β -内酰胺酶为主(90.6%)。mCIM的敏感性和特异性均为100%。经过审查,CLSI M45委员会提出了扩展谱头孢菌素(头孢他啶和头孢吡肟)、碳青霉烯类(美罗培南和亚胺培南)、氟喹诺酮类(环丙沙星和左氧氟沙星)和氨基糖苷类(阿米卡星和妥布霉素)的暂定MIC和DD bp。除铜绿假单胞菌(POPA)外的假单胞菌种类可引起机会性感染,由于各种抗菌素耐药机制,这种感染可能难以治疗。抗菌药物敏感性试验是这些感染患者管理的关键组成部分。目前,临床和实验室标准协会(CLSI) M100非肠杆菌断点和方法被美国临床实验室用于POPA,可能无法准确预测药敏结果。本研究的目的是为POPA建立暂定的CLSI M45 MIC和磁盘扩散断点。并对其耐药机制和改良碳青霉烯类酶灭活检测方法进行了评价。我们提供了CLSI委派的志愿者在M45指南中开发POPA断点所使用的数据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Establishing Clinical and Laboratory Standards Institute M45 antimicrobial susceptibility testing methods and breakpoints for Pseudomonas other than Pseudomonas aeruginosa.

The purpose of this study was to establish tentative Clinical and Laboratory Standards Institute (CLSI) M45 MIC and disk diffusion (DD) breakpoints (BPs) for Pseudomonas other than Pseudomonas aeruginosa (POPA). Mechanisms of antimicrobial resistance (AMR) and the modified carbapenem inactivation method (mCIM) to detect carbapenemase production were also evaluated. MIC data from P. aeruginosa and POPA from 2013 to 2022 were evaluated to compare the MIC distributions and modal MICs relative to the CLSI M100 P. aeruginosa BPs. A disk-to-MIC correlation study with 83 isolates was completed by testing reference broth microdilution and DD from the same inoculum, and the error-rate bounded method was used to establish DD BPs. For most antimicrobials, the modal MICs between P. aeruginosa and POPA were within 1-doubling dilution and lower than the M100 P. aeruginosa-susceptible BP. For amikacin, the modal MIC for POPA was 2-doubling dilutions lower than P. aeruginosa and was evaluated relative to the Enterobacterales BP. For aztreonam and trimethoprim-sulfamethoxazole, the modal MICs were elevated, and no BPs were set. New DD correlates were established for most antimicrobial agents, except for fluoroquinolones, where the P. aeruginosa correlates were suitable. AMR genes conferring resistance to multiple antimicrobial classes were identified by WGS. Beta-lactamase genes were identified in 30 (36.1%) isolates, with metallo-beta-lactamases (90.6%) predominating. The mCIM had a sensitivity and specificity of 100%. Upon review, the CLSI M45 committee proposed tentative MIC and DD BPs for expanded-spectrum cephalosporins (ceftazidime and cefepime), carbapenems (meropenem and imipenem), fluoroquinolones (ciprofloxacin and levofloxacin), and the aminoglycosides (amikacin and tobramycin).IMPORTANCEPseudomonas species other than Pseudomonas aeruginosa (POPA) can cause opportunistic infections which may be difficult to treat due to a variety of antimicrobial resistance mechanisms. Antimicrobial susceptibility testing is a critical component of patient management for these infections. Currently, the Clinical and Laboratory Standards Institute (CLSI) M100 non-Enterobacterales breakpoints and methodology are utilized for POPA by US clinical laboratories and likely do not accurately predict susceptibility results. The purpose of this study was to establish tentative CLSI M45 MIC and disk diffusion breakpoints for POPA. Mechanisms of antimicrobial resistance and the modified carbapenem inactivation method to detect carbapenemase production were also evaluated. We present the data used by the volunteers tasked by CLSI to develop POPA breakpoints in the M45 guidelines.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Journal of Clinical Microbiology
Journal of Clinical Microbiology 医学-微生物学
CiteScore
17.10
自引率
4.30%
发文量
347
审稿时长
3 months
期刊介绍: The Journal of Clinical Microbiology® disseminates the latest research concerning the laboratory diagnosis of human and animal infections, along with the laboratory's role in epidemiology and the management of infectious diseases.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信