Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
König, E; Iser, J; Zechner-Sammer, T; Friedl, H; Krause, R; Valentin, T; Leitner, E; Steinmetz, I; Zollner-Schwetz, I.
Establishing breakpoints for amoxicillin/clavulanate and ampicillin/sulbactam for rapid antimicrobial susceptibility testing directly from positive blood culture bottles.
J Med Microbiol. 2023; 72(3):
Doi: 10.1099/jmm.0.001672
Web of Science
PubMed
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- Führende Autor*innen der Med Uni Graz
- König Elisabeth
- Co-Autor*innen der Med Uni Graz
- Iser Juliane
- Krause Robert
- Leitner-Meyer Eva
- Steinmetz Ivo
- Valentin Thomas
- Zollner-Schwetz Ines
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- Abstract:
- Introduction. In 2018, EUCAST released guidelines on rapid antimicrobial susceptibility testing (RAST) directly from positive blood culture bottles for selected bacterial species and antimicrobial agents, but not for the commonly used agents amoxicillin/clavulanate (AMC) and ampicillin/sulbactam (SAM).Hypothesis/Gap statement. This work addresses the Enterobacterales RAST capability gap for betalactam/betalactamase inhibitor combinations.Aim. We aimed to determine RAST breakpoints for AMC and SAM for Escherichia coli and Klebsiella pneumoniae after 4 and 6 h of incubation directly from positive blood cultures.Methodology. Blood culture bottles were spiked with clinical isolates of E. coli (n=89) and K. pneumoniae (n=81). RAST was performed according to EUCAST guidelines and zones were read after 4 and 6 h. Breakpoints were defined to avoid very major errors.Results. The proportion of readable zone diameters after 4 h of incubation were 90.8 % in E. coli and 85.8 % in K. pneumoniae isolates. After 6 h of incubation all zone diameters could be read. The proposed breakpoints for E. coli after 6 h of incubation were ≥16 mm S (susceptible), 14-15 mm ATU (area of technical uncertainty) and <14 mm R (resistant) for AMC; ≥15 mm S, 12-14 mm ATU and <12 mm R for SAM; for K. pneumoniae these were ≥16 mm S, 14-15 mm ATU and <14 mm R for AMC; ≥13 mm S, 12 mm ATU, <12 mm R for SAM. Applying our newly set breakpoints, major errors were infrequent (2.6 %).Conclusion. We propose novel AMC and SAM breakpoints for RAST directly from positive blood cultures for reading after 4 and 6 h of incubation.
- Find related publications in this database (using NLM MeSH Indexing)
- Sulbactam - pharmacology
- Blood Culture - administration & dosage
- Escherichia coli - administration & dosage
- Ampicillin - pharmacology
- Amoxicillin-Potassium Clavulanate Combination - pharmacology
- Anti-Infective Agents - administration & dosage
- Anti-Bacterial Agents - pharmacology
- Microbial Sensitivity Tests - administration & dosage
- Find related publications in this database (Keywords)
- betalactam
- betalactamase inhibitor combinations
- blood cultures
- bloodstream infection
- rapid antimicrobial susceptibility testing