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定义抗微生物敏感性测试方法和Achromobacter物种之间的断点

Harley Harris¹, Haley Stambaugh¹, Emily Jacobs¹

¹Department of Pathology, Division of Medical Microbiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Journal of clinical microbiology

|April 30, 2025

概括

这项研究为Achromobacter物种建立了初步的抗微生物敏感性测试断点,改善了这些难以治疗的机会性感染的治疗指南. 它还评估了修改的卡巴胺失活法,并确定了耐药性机制.

科学领域:

临床微生物学和传染病.
抗微生物药物耐药性的机制
细菌遗传学和基因组学细菌遗传学和基因组学

背景情况:

阿克罗巴克特菌种是机会性病原体,由于各种抗菌素耐药性 (AMR) 机制,它们会导致难以治疗的感染.
目前临床和实验室标准研究所 (CLSI) 的指导方针缺乏针对Achromobacter物种的特定抗微生物敏感性测试 (AST) 断点.
现有的CLSI M100对非肠杆菌的标准可能不准确地预测了Achromobacter的敏感性.

研究的目的:

为了确定CLSI M45初步的最低抑制度 (MIC) 和磁盘扩散 (DD) 断点,用于Achromobacter物种.
为了评估修改的碳烯胺失活法 (mCIM) 检测碳烯酶生产的性能.
阐明在阿克罗姆巴克特物种中普遍存在的AMR机制.

主要方法:

对当代MIC数据进行对比,以确定暂定流行病学截止值 (tECV).
磁盘与MIC相关研究使用微稀释和磁盘扩散对91个美国分离物进行分析,并使用dBETS软件进行分析.
应用mCIM和全基因组测序 (WGS) 来描述耐药性基因和机制.

主要成果:

建立了初步的ECV:皮佩拉西林-塔扎巴克坦 (1μg/mL),伊米 (2μg/mL) 和美罗 (0.5μg/mL).
磁盘扩散断点满足了CLSI M23的接受标准,只有少数例外.
在90.1%的分离物 (主要是blaOXA-114) 中,WGS确定了blaOXA变异,并在19个分离物 (包括blaAXC,blaVIM-4,blaAZM-1) 中获得了β-乳糖酶基因. mCIM显示了100%的灵敏度和87%的特异性.

结论:

关键剂的初步MIC和磁盘扩散断点由CLSI M45委员会建立.
mCIM是一种敏感的方法,用于检测Achromobacter中的碳酶活性.
WGS提供了关于阿克罗巴克特抗菌耐药性的遗传基础的宝贵见解,指导制定特定的AST指导方针.

关键词:

这种细菌是Achromobacter.对抗微生物的敏感性测试.断点断点断点磁盘扩散是指光盘的扩散.流行病学界限值是指流行病学界限值.最小的抑制度的最小抑制度.

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