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关于Cefiderocol测试的问题:比较商业方法与汁微稀释在缺乏铁的介质中 - 根据EUCAST初始和修订的解释标准对性能,ATU和尾随效应的分析

Stefano Stracquadanio¹, Alice Nicolosi¹, Andrea Marino²

¹Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy.

Diagnostics (Basel, Switzerland)

|October 25, 2024

概括

准确的塞菲德罗科尔敏感性测试对于治疗多药耐药的格拉姆阴性细菌至关重要. 目前的商业方法存在局限性,需要仔细解释和潜在的补充测试,以获得有效的抗生素治疗.

科学领域:

抗微生物耐药性抗微生物耐药性
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.

背景情况:

越来越多的抗药性格拉姆阴性细菌需要新型抗菌剂.
塞菲德罗科尔利用细菌的铁吸收来透外膜.
这项研究涉及Cefiderocol的疗效和测试方法.

研究的目的:

评估 cefiderocol 测试方法: ComASP® 面板,磁盘扩散 (DD) 和 MIC 测试条 (MTS).
评估尾行效应对二醇最小抑制度 (MIC) 确定的影响.
将商业方法与缺铁微稀释 (ID-BMD) 作为黄金标准进行比较.

主要方法:

使用商业赛菲德罗科尔测试和ID-BMD测试测试了131个格兰阴性临床分离物.
根据EUCAST指南 (2023年和2024年) 解释结果.
分析了每个方法的分类和基本一致性,以及每个方法的错误率.

主要成果:

在Enterobacterales和*Pseudomonas aeruginosa*中观察到高CEFIDEROCOL敏感性.
*Acinetobacter baumannii*显示出较高的MIC,并由后续效应复杂化.
商业方法与ID-BMD显示出可变的一致性;ComASP®错过了耐药的*K.肺炎*,DD具有可变的CA,MTS低估了*P.aeruginosa*的MIC.

结论:

对于尾随效应和模两可的抑制区 (ATU) 需要标准化的标准.
塞菲德罗科尔测试方法之间的差异凸显了商业套件的局限性.
准确的敏感性测试对于塞菲德罗科尔的临床实用性至关重要,需要仔细解释和潜在的确认性测试.

关键词:

在 AST AST AST 中.ATU ATU 的意思是在Cefiderocol中使用.拖行效应的拖行效应

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