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antibiogram interpretation

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https://www.readbyqxmd.com/read/28859448/master-a-model-to-improve-and-standardize-clinical-breakpoints-for-antimicrobial-susceptibility-testing-using-forecast-probabilities
#1
Nicolas Blöchliger, Peter M Keller, Erik C Böttger, Michael Hombach
Objectives: The procedure for setting clinical breakpoints (CBPs) for antimicrobial susceptibility has been poorly standardized with respect to population data, pharmacokinetic parameters and clinical outcome. Tools to standardize CBP setting could result in improved antibiogram forecast probabilities. We propose a model to estimate probabilities for methodological categorization errors and defined zones of methodological uncertainty (ZMUs), i.e. ranges of zone diameters that cannot reliably be classified...
September 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28491246/significance-of-coagulase-negative-staphylococcus-from-blood-cultures-persisting-problems-and-partial-progress-in-resource-constrained-settings
#2
Shailpreet K Sidhu, Sita Malhotra, Pushpa Devi, Arpandeep K Tuli
BACKGROUND AND OBJECTIVES: Coagulase negative Staphylococcus (CoNS) is frequently isolated from blood cultures but their significance is difficult to interpret. CoNS bacteria which are often previously dismissed as culture contaminants are attracting greater importance as true pathogens in the past decades. Clinical evaluation of these isolates suggests that although there is a relative increase of CoNS associated bloodstream infections in recent years, the microorganisms still remain the most common contaminants in blood cultures...
December 2016: Iranian Journal of Microbiology
https://www.readbyqxmd.com/read/28468851/whole-genome-sequencing-reveals-the-contribution-of-long-term-carriers-in-staphylococcus-aureus-outbreak-investigation
#3
N C Gordon, B Pichon, T Golubchik, D J Wilson, J Paul, D S Blanc, K Cole, J Collins, N Cortes, M Cubbon, F K Gould, P J Jenks, M Llewelyn, J Q Nash, J M Orendi, K Paranthaman, J R Price, L Senn, H L Thomas, S Wyllie, D W Crook, T E A Peto, A S Walker, A M Kearns
Whole-genome sequencing (WGS) makes it possible to determine the relatedness of bacterial isolates at a high resolution, thereby helping to characterize outbreaks. However, for Staphylococcus aureus, the accumulation of within-host diversity during carriage might limit the interpretation of sequencing data. In this study, we hypothesized the converse, namely, that within-host diversity can in fact be exploited to reveal the involvement of long-term carriers (LTCs) in outbreaks. We analyzed WGS data from 20 historical outbreaks and applied phylogenetic methods to assess genetic relatedness and to estimate the time to most recent common ancestor (TMRCA)...
July 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28432607/impact-of-the-medical-specialty-on-knowledge-regarding-multidrug-resistant-organisms-and-strategies-toward-antimicrobial-stewardship
#4
Steffen Lebentrau, Christian Gilfrich, Malte W Vetterlein, Harald Schumacher, Philipp J Spachmann, Sabine D Brookman-May, Hans M Fritsche, Martin Schostak, Florian M Wagenlehner, Maximilian Burger, Matthias May
PURPOSE: Evidence is scarce on subject-specific knowledge of multidrug-resistant organisms and rational use of antibiotics. We aimed at evaluating attitude, perception, and knowledge about multidrug-resistant organisms (MDRO) and antibiotic prescribing among urologists versus other medical specialties. METHODS: Within the MR2-study (Multiinstitutional Reconnaissance of practice with MultiResistant bacteria), a questionnaire was conducted targeting general surgeons, internists, gynecologists, and urologists in 18 German hospitals...
August 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28365324/clinical-features-and-antimicrobial-resistance-profiles-of-important-enterobacteriaceae-pathogens-in-guangzhou-representative-of-southern-china-2001-2015
#5
Jinhong Xie, Brian M Peters, Bing Li, Lin Li, Guangchao Yu, Zhenbo Xu, Mark E Shirtliff
OBJECT: This surveillance aimed to investigate the antimicrobial resistance profiles of Enterobacteriaceae pathogens in Southern China during 2001-2015. METHODS: A total of 6858 Enterobacteriaceae isolates were collected, including 4276 E. coli, 1992 K. pneumoniae and 590 Enterobacter spp. Disk diffusion method and minimum inhibitory concentrations method were used for susceptibility testing, with results interpreted by the CLSI (2015). RESULTS: Urinary tract remained the dominant isolated site among E...
March 29, 2017: Microbial Pathogenesis
https://www.readbyqxmd.com/read/28260148/anticipating-the-unpredictable-a-review-of-antimicrobial-stewardship-and-acinetobacter-infections
#6
REVIEW
Eric Wenzler, Debra A Goff, Romney Humphries, Ellie J C Goldstein
Acinetobacter remains one of the most challenging pathogens in the field of infectious diseases owing primarily to the uniqueness and multiplicity of its resistance mechanisms. This resistance often leads to devastatingly long delays in time to appropriate therapy and increased mortality for patients afflicted with Acinetobacter infections. Selecting appropriate empiric and definitive antibacterial therapy for Acinetobacter is further complicated by the lack of reliability in commercial antimicrobial susceptibility testing devices and limited breakpoint interpretations for available agents...
June 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/28129815/-dalbavancin-breakpoints-and-recommendations-for-in-vitro-study-of-its-activity
#7
Rafael Cantón, María Díez-Aguilar, María Isabel Morosini
Dalbavancin is a semisynthetic lipoglycopeptide approved for the treatment of acute skin and soft tissue infections due to Gram-positive microorganisms susceptible to this antimicrobial agent. The FDA (Food and Drug Administration) and the EUCAST (European Committee on Antimicrobial Susceptibility Testing) have established clinical breakpoints to interpret the results of the antibiogram (expressed as MIC [minimum inhibitory concentration]) with approved doses (1g intravenously [IV] followed by 0.5g IV at day 8 or 1...
January 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/27986824/the-intersection-of-antimicrobial-stewardship-and-microbiology-educating-the-next-generation-of-health-care-professionals
#8
Lauren A O'Donnell, Anthony J Guarascio
With the alarming rise of antibiotic resistance, clinical professionals are called upon to manage antibiotic therapies using the most relevant and recent clinical and laboratory data. To this end, antimicrobial stewardship (AMS) programs aim to reduce unnecessary or suboptimal use of antibiotics while maximizing outcomes for the patient. For AMS programs to succeed, the active participation of clinical professionals at all levels of patient care is required. Although programs exist to train established clinicians in AMS, there is a paucity of literature on how and when to integrate AMS concepts and skills in pre-clinical and clinical coursework...
January 2017: FEMS Microbiology Letters
https://www.readbyqxmd.com/read/27384826/antimicrobial-susceptibility-of-acinetobacter-clinical-isolates-and-emerging-antibiogram-trends-for-nosocomial-infection-management
#9
COMPARATIVE STUDY
Muhammad Sohail, Abid Rashid, Bilal Aslam, Muhammad Waseem, Muhammad Shahid, Muhammad Akram, Mohsin Khurshid, Muhammad Hidayat Rasool
INTRODUCTION: The drug resistant Acinetobacter strains are important causes of nosocomial infections that are difficult to control and treat. This study aimed to determine the antimicrobial susceptibility patterns of Acinetobacter strains isolated from different clinical specimens obtained from patients belonging to different age groups. METHODS: In total, 716 non-duplicate Acinetobacter isolates were collected from the infected patients admitted to tertiary-care hospitals at Lahore, Pakistan, over a period of 28 months...
May 2016: Revista da Sociedade Brasileira de Medicina Tropical
https://www.readbyqxmd.com/read/27070064/understanding-bacterial-isolates-in-blood-culture-and-approaches-used-to-define-bacteria-as-contaminants-a-literature-review
#10
REVIEW
Belal Hossain, Mohammad Shahidul Islam, Atiqur Rahman, Mahfuza Marzan, Iftekhar Rafiqullah, Nicholas E Connor, Mohammad Hasanuzzaman, Maksuda Islam, Davidson H Hamer, Patricia L Hibberd, Samir K Saha
BACKGROUND: Interpretation of blood culture isolates is challenging due to a lack of standard methodologies for identifying contaminants. This problem becomes more complex when the specimens are from sick young infants, as a wide range of bacteria can cause illness among this group. METHODS: We used 43 key words to find articles published between 1970 and 2011 on blood culture isolates and possible contaminants in the PubMed database. Experts were also consulted to obtain other relevant articles...
May 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/26855737/epidemiologic-and-drug-resistance-pattern-of-vibrio-cholerae-o1-biotype-el-tor-serotype-ogawa-in-the-2011-cholera-outbreak-in-alborz-province-iran
#11
Hojatolah Barati, Ghobad Moradi, Mohammad Aziz Rasouli, Parvin Mohammadi
BACKGROUND: Although the national guidelines recommend special antibiotics, based on the antibiogram of National Reference Laboratory, it seems that, because of uncontrolled usage of antibiotics in the society and due to the changes in the serotypes causing the disease, it is essential to monitor the status of drug resistance, permanently, and to revise the current prescriptions guidelines. OBJECTIVES: This study aimed to assess the epidemiological aspects and drug resistance pattern of Vibrio cholerae O1, biotype El Tor, serotype Ogawa, in cholera outbreak, in Alborz province in Iran, during 2011...
November 2015: Jundishapur Journal of Microbiology
https://www.readbyqxmd.com/read/26814675/analysis-and-presentation-of-cumulative-antimicrobial-susceptibility-test-data-the-influence-of-different-parameters-in-a-routine-clinical-microbiology-laboratory
#12
Rebekka Kohlmann, Sören G Gatermann
INTRODUCTION: Many clinical microbiology laboratories report on cumulative antimicrobial susceptibility testing (cAST) data on a regular basis. Criteria for generation of cAST reports, however, are often obscure and inconsistent. Whereas the CLSI has published a guideline for analysis and presentation of cAST data, national guidelines directed at clinical microbiology laboratories are not available in Europe. Thus, we sought to describe the influence of different parameters in the process of cAST data analysis in the setting of a German routine clinical microbiology laboratory during 2 consecutive years...
2016: PloS One
https://www.readbyqxmd.com/read/26645023/nasal-carriage-of-methicillin-and-mupirocin-resistant-s-aureus-among-health-care-workers-in-a-tertiary-care-hospital
#13
Loveleena Agarwal, Amit Kumar Singh, Chandrim Sengupta, Amitabh Agarwal
OBJECTIVE: Methicillin-resistant Staphylococcus aureus (MRSA) ranks top among the nosocomial pathogens. Nasal formulation of mupirocin is found to eradicate MRSA from colonized individuals, but the emergence of resistant strains is a matter of concern. METHODS: Nasal swabs were collected from 200 health care workers (HCWs) who were screened for MRSA. Kirby-Bauer disc diffusion method was used to perform antibiotic susceptibility test. MRSA detection was done using a cefoxitin 30 µg disc and interpreted according to the Clinical and Laboratory Standards Institute guidelines...
October 2015: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/26323611/interpretative-reading-of-the-antibiogram-a-semi-na%C3%A3-ve-bayesian-approach
#14
Steen Andreassen, Alina Zalounina, Mical Paul, Line Sanden, Leonard Leibovici
BACKGROUND: An antibiogram (ABG) gives the results of in vitro susceptibility tests performed on a pathogen isolated from a culture of a sample taken from blood or other tissues. The institutional cross-ABG consists of the conditional probability of susceptibility for pairs of antimicrobials. This paper explores how interpretative reading of the isolate ABG can be used to replace and improve the prior probabilities stored in the institutional ABG. Probabilities were calculated by both a naïve and semi-naïve Bayesian approaches, both using the ABG for the given isolate and institutional ABGs and cross-ABGs...
November 2015: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/25890362/evaluation-of-regional-antibiograms-to-monitor-antimicrobial-resistance-in-hampton-roads-virginia
#15
Susette K Var, Rouba Hadi, Nancy M Khardori
We studied recent antibiograms (2010 to 2011) from 12 hospitals in the Hampton Roads area, Virginia, that refer patients to a tertiary-care facility affiliated with Eastern Virginia Medical School. The data was compiled into a regional antibiogram, and sensitivity rates of common isolates from the tertiary-care facility (central) were compared to those of referring hospitals grouped by locale. Staphylococcus aureus was the most common Gram- positive and E. coli the most common Gram- negative organism grown from clinical samples in the area...
2015: Annals of Clinical Microbiology and Antimicrobials
https://www.readbyqxmd.com/read/25230549/central-venous-catheter-related-bloodstream-infections-in-medical-intensive-care-unit-patients-in-a-tertiary-referral-centre
#16
Deepti, Sanjeev Sinha, Surendra K Sharma, Praveen Aggarwal, Ashutosh Biswas, Seema Sood, P Ragunandan, Meera Ekka, Immaculata Xess, V Sreenivas
AIMS: To determine the incidence of central line associated bloodstream infections (CLABSIs) in the medical intensive care unit (ICU) and ward setting at All India Institute of Medical Sciences (AIIMS), New Delhi. SETTINGS AND DESIGN: The study was conducted in the medical ICU, a 9-bedded ICU at the AIIMS, a tertiary care teaching hospital. The study design was a prospective observational study. METHODS: One hundred patients admitted to medical ICU and the ward at AIIMS with an indwelling, non-tunnelled central venous catheter (CVC) in place at admission and those with a hospital stay with indwelling CVC for more than 48 hours were monitored...
April 2014: Indian Journal of Chest Diseases & Allied Sciences
https://www.readbyqxmd.com/read/25100821/integrating-forecast-probabilities-in-antibiograms-a-way-to-guide-antimicrobial-prescriptions-more-reliably
#17
Florian P Maurer, Patrice Courvalin, Erik C Böttger, Michael Hombach
Antimicrobial susceptibility testing (AST) assigns pathogens to "susceptible" or "resistant" clinical categories based on clinical breakpoints (CBPs) derived from MICs or inhibition zone diameters and indicates the likelihood for therapeutic success. AST reports do not provide quantitative measures for the reliability of such categorization. Thus, it is currently impossible for clinicians to estimate the technical forecast uncertainty of an AST result regarding clinical categorization. AST error rates depend on the localization of pathogen populations in relation to CBPs...
October 2014: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/24817913/a-study-of-antibiogram-of-salmonella-enterica-serovar-typhi-isolates-from-pondicherry-india
#18
Sreenivasan Srirangaraj, Arunava Kali, M V Pravin Charles
BACKGROUND: Enteric fever caused by Salmonella enterica serovar Typhi (S. Typhi) is an important public health problem in developing countries like India.1 The emergence of resistance to fluoroquinolones has reduced the therapeutic options available. Currently, the uniform laboratory interpretation of ciprofloxacin and azithromycin susceptibility remains unclear. AIMS: To study the antibiogram of S. Typhi isolates with special emphasis on in-vitro activity of ciprofloxacin and azithromycin...
2014: Australasian Medical Journal
https://www.readbyqxmd.com/read/24223893/change-of-antibiotic-susceptibility-testing-guidelines-from-clsi-to-eucast-influence-on-cumulative-hospital-antibiograms
#19
Aline Wolfensberger, Hugo Sax, Rainer Weber, Reinhard Zbinden, Stefan P Kuster, Michael Hombach
OBJECTIVE: We studied whether the change in antibiotic susceptibility testing (AST) guidelines from CLSI to EUCAST influenced cumulative antibiograms in a tertiary care hospital in Switzerland. METHODS: Antibiotic susceptibilities of non-duplicate isolates collected within a one-year period before (period A) and after (period B) changing AST interpretation from CLSI 2009 to EUCAST 1.3 (2011) guidelines were analysed. In addition, period B isolates were reinterpreted according to the CLSI 2009, CLSI 2013 and EUCAST 3...
2013: PloS One
https://www.readbyqxmd.com/read/24151444/the-high-diversity-of-mrsa-clones-detected-in-a-university-hospital-in-istanbul
#20
Lutfiye Oksuz, Celine Dupieux, Anne Tristan, Michele Bes, Jerome Etienne, Nezahat Gurler
BACKGROUND: To characterize the methicillin-resistant Staphylococcus aureus (MRSA) clones present in Istanbul, 102 MRSA isolates collected during a 5-year period at the Istanbul Medical Faculty Hospital were characterized using microarray analysis and phenotypic resistance profiles. METHODS: Resistance to methicillin was detected with a cefoxitin disk diffusion assay and confirmed with a MRSA-agar and MRSA detection kit. Antimicrobial susceptibility testing was performed by a disk diffusion assay and interpreted according to the 2012 guidelines of the Antibiogram Committee of the French Society for Microbiology...
2013: International Journal of Medical Sciences
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