Expert Consensus on Polymyxin Antimicrobial Susceptibility Testing and Clinical Interpretation

Area of Science:

• Microbiology
• Clinical Pharmacy

Background:

• Polymyxins are crucial for treating infections caused by antibiotic-resistant gram-negative bacteria.
• Conflicting international guidelines on polymyxin susceptibility testing create challenges for Chinese laboratorians and clinicians.

Purpose of the Study:

• To clarify polymyxin susceptibility testing methods and interpretation standards for Chinese laboratories.
• To address the inconsistencies in clinical breakpoints set by international bodies.

Main Methods:

• Convening experts from relevant fields to develop a consensus statement.
• Reviewing and analyzing existing international guidelines from CLSI and EUCAST.
• Formulating practical recommendations for daily laboratory work.

Main Results:

• Identified discrepancies between the Clinical and Laboratory Standards Institute (CLSI) and the European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoint recommendations.
• Highlighted the difficulties faced by Chinese laboratorians in performing and interpreting polymyxin susceptibility tests.

Conclusions:

• A standardized approach to polymyxin susceptibility testing and interpretation is urgently needed in China.
• The consensus statement provides clear recommendations to streamline daily practices for laboratorians and clinicians.
• Accurate testing and interpretation will improve the clinical management of infections caused by resistant gram-negative bacilli.