媒体品牌对Cefiderocol磁盘扩散结果的影响
M G DeMarco1, A M Field1, L E Donohue1
1Department of Pharmacy Services, University of Virginia Health, Charlottesville, Virginia, USA.
Journal of clinical microbiology
|March 25, 2025
概括
塞菲德罗科尔磁盘扩散试验显示了亚گار品牌的变异性,特别是耐药细菌. 标准化方法对于准确的抗微生物敏感性测试 (AST) 至关重要,以指导多药耐药性感染的治疗.
科学领域:
- 微生物学 微生物学
- 临床诊断 临床诊断 临床诊断
- 抗微生物耐药性 抗微生物耐药性
背景情况:
- 塞菲德罗科尔是一种新型的 siderophore cephalosporin,有效对抗多药耐药的阴性细菌.
- 准确的抗微生物敏感性测试 (AST) 对于 cefiderocol至关重要,因为耐药性可能导致治疗失败.
- 标准的磁盘扩散 (DD) 方法可能会面临挑战,因为 cefiderocol 的依赖铁的吸收机制.
研究的目的:
- 为了研究不同商业型穆勒-欣顿 (MHA) 品牌中 cefiderocol盘扩散 (DD) 结果的变异性.
- 为了比较DD结果与缺铁微稀释 (BMD) 用于测试 cefiderocol易感性.
- 在临床实验室中识别影响DD对CefiderocolAST可靠性的潜在问题.
主要方法:
- 评估了使用三种MHA品牌 (Remel,Hardy,BBL) 对铁贫的BMD的Cefiderocol DD结果.
- 测试了47个多抗药性临床分离物和3个参考菌株,包括*Pseudomonas aeruginosa*,耐卡巴胺的肠杆菌 (CRE) 和*Acinetobacter baumannii*复合物.
- 评估的可复制性,在BMD中的尾随终点,以及在DD抑制区域中的品牌内和品牌间的变异性.
主要成果:
- 只有使用CLSI断点的BBL agar才能达到≥90%的分类一致性 (CA).
- 对于 *P. aeruginosa* 和 CRE. 的DD结果,观察到高的品牌内和品牌间的变化.
- 不一致的AST解释经常发生,特别是对于 BMD 对基醇不敏感的分离物,导致潜在的错误分类.
结论:
- 商业MHA品牌在Cefiderocol DD测试中表现出显著的变化,影响了准确性.
- 复制性问题,特别是对于耐药分离物,需要重新评估当前的DD方法和质量控制.
- 实用和可重复方法的标准化对于在临床环境中可靠的 cefiderocol AST至关重要.
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