在2023年引入CLSI M100的新面孔:一个解释性审查
Sumit Rai1, Debabrata Dash1, Nidhima Agarwal1
1Department of Clinical Microbiology, AIIMS Mangalagiri, Guntur, India.
Indian journal of medical microbiology
|November 9, 2023
概括
临床和实验室标准研究所 (CLSI) M100-Ed33更新引入了对抗生素敏感性测试 (AST) 指南的重大变化,重点关注PK/PD数据和生物体特定的断点,以改善临床实践.
科学领域:
- 临床微生物学 临床微生物学
- 药理学 药理学是指药理学的学科.
- 传染性疾病 传染性疾病
背景情况:
- 临床和实验室标准协会 (CLSI) 年度M100文件更新 (M100-Ed33) 显著影响临床实践.
- 关键的变化集中在药理动力学/药理动力学 (PK/PD) 数据,选择性/级联报告和治疗评论上.
研究的目的:
- 为了阐明CLSI M100-Ed33变更背后的逻辑.
- 解释更新的抗生素敏感性测试 (AST) 指南的临床含义.
主要方法:
- 从经典的抗生素分组 (A,B,U,O) 转向基于层级的方法 (层1至4) 进行AST中增强级联报告.
- 从基于生物的分组 (非繁杂,繁杂,无氧) 过渡到生物特异表.
- 对Enterobacterales和Pseudomonas aeruginosa的氨基糖化物中断点的修订.
主要成果:
- 在P. aeruginosa.中更新了piperacillin-tazobactam (TZP) 的断点.
- 断点的变化主要是基于实现细菌静止的药物血水平,不一定是杀菌效应.
- 建议使用阿米诺糖化物进行组合治疗,对于P. aeruginosa而言取消了甘他,而阿米卡仅限于尿路分离物.
结论:
- 更新的CLSI M100-Ed33促进了对AST报告和解释的更精细的方法.
- 更新的断点和报告策略旨在优化抗生素选择并改善患者的治疗结果.
- 这些变化强调了PK/PD数据和组合治疗在抗菌药物管理中的重要性.
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