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Related Concept Videos

Urine Studies II: Urine Culture and Sensitivity Test01:26

Urine Studies II: Urine Culture and Sensitivity Test

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A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...
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Antimicrobial Effectiveness01:28

Antimicrobial Effectiveness

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The effectiveness of antimicrobial agents depends on various factors influencing their ability to eliminate microbial populations. Larger microbial populations require more time for complete eradication, emphasizing the importance of population size analysis when evaluating antimicrobial efficacy.Microbial resistance to antimicrobial agents varies significantly. Highly resilient microorganisms include endospores, gram-negative bacteria, and non-enveloped viruses, while prions are exceptionally...
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Less Is More: When to Repeat Antimicrobial Susceptibility Testing.

Maarten J Sarink1, Lonneke G M Bode1, Peter Croughs1

  • 1Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands.

Journal of Clinical Microbiology
|July 12, 2023
PubMed
Summary
This summary is machine-generated.

Antimicrobial resistance in common bacteria like E. coli and S. aureus changes slowly. For many infections, repeat susceptibility testing within 7 days may not be necessary, saving resources and reducing waste.

Keywords:
VITEKantimicrobial susceptibility testingclinical microbiology laboratorycostslaboratory managementphenotypic resistance

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Area of Science:

  • Clinical Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Antimicrobial susceptibility patterns can change over time within the same patient.
  • Monitoring these changes is crucial for effective treatment and infection control.
  • The frequency and predictability of resistance development require further investigation.

Purpose of the Study:

  • To investigate the frequency of changes in antimicrobial susceptibility patterns for common bacterial pathogens.
  • To evaluate the risk of developing resistance over different follow-up periods.
  • To assess the feasibility of omitting routine follow-up antimicrobial susceptibility testing.

Main Methods:

  • Retrospective analysis of 18,501 antimicrobial susceptibility tests (AST) from January 2014 to December 2021.
  • Focus on Escherichia coli, Klebsiella pneumoniae, Enterobacter spp., Pseudomonas aeruginosa, and Staphylococcus aureus.
  • Utilized Vitek 2 system, determining essential and categorical agreement, and introducing new metrics for resistance changes.

Main Results:

  • Staphylococcus aureus showed a <10% risk of resistance within 30 days.
  • Enterobacterales exhibited approximately 10% risk of resistance within 7 days.
  • Pseudomonas aeruginosa demonstrated a higher risk of resistance with longer follow-up periods; specific drug-bug combinations (e.g., E. coli/amoxicillin-clavulanic acid) were more prone to resistance.

Conclusions:

  • A follow-up AST risk below 10% suggests omitting repeat testing within 7 days may be feasible for certain bacteria.
  • This approach could lead to significant cost, time, and laboratory waste savings.
  • Further research is needed to balance economic benefits against the risk of suboptimal antibiotic treatment.