Swathi Suravaram1, Vivek Hada2, Imran Ahmed Siddiqui3. 1. Department of Microbiology, ESIC Medical College & Hospital, Sanathnagar, Hyderabad, India. 2. Department of Microbiology, All India Institute of Medical Sciences, Gorakhpur, India. Electronic address: vivekhada7285@gmail.com. 3. Department of Biochemistry, ESIC Medical College & Hospital, Sanathnagar, Hyderabad, India.
Abstract
PURPOSE: To determine the difference in antimicrobial susceptibility of various antibiotics using the CLSI & EUCAST breakpoints. METHODS: In this non interventional, retrospective observational study, we reviewed minimum inhibitory concentrations (MIC) of various antibiotics routinely reported for Enterobacteriaceae clinical isolates, from an automated microbiology identification system (VITEK-2). These MICs were then analysed using both CLSI 2019 and EUCAST 2019 guidelines and classified as per the breakpoints into various categories. RESULTS: The concordance rates of the antimicrobial susceptibility for various drugs ranged from 78.2% to 100% among two breakpoints. Perfect agreement with κ = 1 (p < 0.001) was observed for only three antimicrobials ceftriaxone, levofloxacin and trimethoprim-sulfamethoxazole. The changes in antimicrobial susceptibility interpretation for cefepime, ciprofloxacin, amoxicillin clavulanic acid was majorly in Intermediate category. CONCLUSION: The change in interpretation of the susceptibility will lead to change in the usage of antibiotics especially due to recent change in definition of I by EUCAST. There is need of more studies in this aspect to ascertain clinical implication of change in antimicrobial susceptibility.
PURPOSE: To determine the difference in antimicrobial susceptibility of various antibiotics using the CLSI & EUCAST breakpoints. METHODS: In this non interventional, retrospective observational study, we reviewed minimum inhibitory concentrations (MIC) of various antibiotics routinely reported for Enterobacteriaceae clinical isolates, from an automated microbiology identification system (VITEK-2). These MICs were then analysed using both CLSI 2019 and EUCAST 2019 guidelines and classified as per the breakpoints into various categories. RESULTS: The concordance rates of the antimicrobial susceptibility for various drugs ranged from 78.2% to 100% among two breakpoints. Perfect agreement with κ = 1 (p < 0.001) was observed for only three antimicrobials ceftriaxone, levofloxacin and trimethoprim-sulfamethoxazole. The changes in antimicrobial susceptibility interpretation for cefepime, ciprofloxacin, amoxicillin clavulanic acid was majorly in Intermediate category. CONCLUSION: The change in interpretation of the susceptibility will lead to change in the usage of antibiotics especially due to recent change in definition of I by EUCAST. There is need of more studies in this aspect to ascertain clinical implication of change in antimicrobial susceptibility.
Authors: Travis J Kochan; Sophia H Nozick; Rachel L Medernach; Bettina H Cheung; Samuel W M Gatesy; Marine Lebrun-Corbin; Sumitra D Mitra; Natalia Khalatyan; Fiorella Krapp; Chao Qi; Egon A Ozer; Alan R Hauser Journal: BMC Infect Dis Date: 2022-07-07 Impact factor: 3.667