Impact of changes in CLSI and EUCAST breakpoints for susceptibility in bloodstream infections due to extended-spectrum beta-lactamase-producing Escherichia coli

The impact of recent changes in and discrepancies between the breakpoints for cephalosporins and other antimicrobials, as determined by CLSI and European Committee on Antimicrobial Susceptibility Testing (EUCAST), was analysed in patients with bloodstream infections caused by extended-spectrum β-lac...

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Autores: Rodríguez-Baño, Jesús, Picón, Eduardo, Navarro, M. D., López Cerero, Lorena, Pascual Hernández, Álvaro
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2012
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/171515
Acceso en línea:https://hdl.handle.net/11441/171515
https://doi.org/10.1111/j.1469-0691.2011.03673.x
Access Level:acceso abierto
Palabra clave:Bloodstream infections
Breakpoints
Cephalosporins
Escherichia coli
Extended-spectrum β-lactamases
Therapy
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spelling Impact of changes in CLSI and EUCAST breakpoints for susceptibility in bloodstream infections due to extended-spectrum beta-lactamase-producing Escherichia coliRodríguez-Baño, JesúsPicón, EduardoNavarro, M. D.López Cerero, LorenaPascual Hernández, ÁlvaroBloodstream infectionsBreakpointsCephalosporinsEscherichia coliExtended-spectrum β-lactamasesTherapyThe impact of recent changes in and discrepancies between the breakpoints for cephalosporins and other antimicrobials, as determined by CLSI and European Committee on Antimicrobial Susceptibility Testing (EUCAST), was analysed in patients with bloodstream infections caused by extended-spectrum β-lactamase (ESBL) producing Escherichia coli in Spain, was analysed. We studied a cohort of 191 episodes of bloodstream infection caused by ESBL-producing E. coli in 13 Spanish hospitals; the susceptibility of isolates to different antimicrobials was investigated by microdilution and interpreted according to recommendations established in 2009 and 2010 by CLSI, and in 2011 by EUCAST. Overall, 58.6% and 14.7% of isolates were susceptible to ceftazidime, and 35.1% and 14.7% to cefepime using the CLSI-2010 and EUCAST-2009/2011 recommendations, respectively (all isolates would have been considered resistant using the previous guidelines). Discrepancies between the CLSI-2010 and the EUCAST-2011 recommendations were statistically significant for other antimicrobials only in the case of amikacin (98.4% versus 75.9% of susceptible isolates; p <0.01). The results varied depending on the ESBL produced. No significant differences were found in the percentage of patients classified as receiving appropriate therapy, following the different recommendations. Four out of 11 patients treated with active cephalosporins according to CLSI-2010 guidelines died (all had severe sepsis or shock); these cases would have been considered resistant according to EUCAST-2011. In conclusion, by using current breakpoints, extended-spectrum cephalosporins would be regarded as active agents for treating a significant proportion of patients with bloodstream infections caused by ESBL-producing E. coli.ElsevierMedicinaMicrobiologíaCTS210: Resistencia a AntimicrobianosEuropean Commission (EC). Fondo Europeo de Desarrollo Regional (FEDER)Instituto de Salud Carlos IIIJunta de AndalucíaMinisterio de Ciencia e Innovación2012info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/171515https://doi.org/10.1111/j.1469-0691.2011.03673.xreponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésClinical Microbiology and Infection, 18 (9), 894-900.0063/20060048/2008CTS-5259REIPI RD06/0008https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(14)61069-7/fulltextinfo:eu-repo/semantics/openAccessoai:idus.us.es:11441/1715152026-06-17T12:51:07Z
dc.title.none.fl_str_mv Impact of changes in CLSI and EUCAST breakpoints for susceptibility in bloodstream infections due to extended-spectrum beta-lactamase-producing Escherichia coli
title Impact of changes in CLSI and EUCAST breakpoints for susceptibility in bloodstream infections due to extended-spectrum beta-lactamase-producing Escherichia coli
spellingShingle Impact of changes in CLSI and EUCAST breakpoints for susceptibility in bloodstream infections due to extended-spectrum beta-lactamase-producing Escherichia coli
Rodríguez-Baño, Jesús
Bloodstream infections
Breakpoints
Cephalosporins
Escherichia coli
Extended-spectrum β-lactamases
Therapy
title_short Impact of changes in CLSI and EUCAST breakpoints for susceptibility in bloodstream infections due to extended-spectrum beta-lactamase-producing Escherichia coli
title_full Impact of changes in CLSI and EUCAST breakpoints for susceptibility in bloodstream infections due to extended-spectrum beta-lactamase-producing Escherichia coli
title_fullStr Impact of changes in CLSI and EUCAST breakpoints for susceptibility in bloodstream infections due to extended-spectrum beta-lactamase-producing Escherichia coli
title_full_unstemmed Impact of changes in CLSI and EUCAST breakpoints for susceptibility in bloodstream infections due to extended-spectrum beta-lactamase-producing Escherichia coli
title_sort Impact of changes in CLSI and EUCAST breakpoints for susceptibility in bloodstream infections due to extended-spectrum beta-lactamase-producing Escherichia coli
dc.creator.none.fl_str_mv Rodríguez-Baño, Jesús
Picón, Eduardo
Navarro, M. D.
López Cerero, Lorena
Pascual Hernández, Álvaro
author Rodríguez-Baño, Jesús
author_facet Rodríguez-Baño, Jesús
Picón, Eduardo
Navarro, M. D.
López Cerero, Lorena
Pascual Hernández, Álvaro
author_role author
author2 Picón, Eduardo
Navarro, M. D.
López Cerero, Lorena
Pascual Hernández, Álvaro
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Medicina
Microbiología
CTS210: Resistencia a Antimicrobianos
European Commission (EC). Fondo Europeo de Desarrollo Regional (FEDER)
Instituto de Salud Carlos III
Junta de Andalucía
Ministerio de Ciencia e Innovación
dc.subject.none.fl_str_mv Bloodstream infections
Breakpoints
Cephalosporins
Escherichia coli
Extended-spectrum β-lactamases
Therapy
topic Bloodstream infections
Breakpoints
Cephalosporins
Escherichia coli
Extended-spectrum β-lactamases
Therapy
description The impact of recent changes in and discrepancies between the breakpoints for cephalosporins and other antimicrobials, as determined by CLSI and European Committee on Antimicrobial Susceptibility Testing (EUCAST), was analysed in patients with bloodstream infections caused by extended-spectrum β-lactamase (ESBL) producing Escherichia coli in Spain, was analysed. We studied a cohort of 191 episodes of bloodstream infection caused by ESBL-producing E. coli in 13 Spanish hospitals; the susceptibility of isolates to different antimicrobials was investigated by microdilution and interpreted according to recommendations established in 2009 and 2010 by CLSI, and in 2011 by EUCAST. Overall, 58.6% and 14.7% of isolates were susceptible to ceftazidime, and 35.1% and 14.7% to cefepime using the CLSI-2010 and EUCAST-2009/2011 recommendations, respectively (all isolates would have been considered resistant using the previous guidelines). Discrepancies between the CLSI-2010 and the EUCAST-2011 recommendations were statistically significant for other antimicrobials only in the case of amikacin (98.4% versus 75.9% of susceptible isolates; p <0.01). The results varied depending on the ESBL produced. No significant differences were found in the percentage of patients classified as receiving appropriate therapy, following the different recommendations. Four out of 11 patients treated with active cephalosporins according to CLSI-2010 guidelines died (all had severe sepsis or shock); these cases would have been considered resistant according to EUCAST-2011. In conclusion, by using current breakpoints, extended-spectrum cephalosporins would be regarded as active agents for treating a significant proportion of patients with bloodstream infections caused by ESBL-producing E. coli.
publishDate 2012
dc.date.none.fl_str_mv 2012
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/171515
https://doi.org/10.1111/j.1469-0691.2011.03673.x
url https://hdl.handle.net/11441/171515
https://doi.org/10.1111/j.1469-0691.2011.03673.x
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Clinical Microbiology and Infection, 18 (9), 894-900.
0063/2006
0048/2008
CTS-5259
REIPI RD06/0008
https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(14)61069-7/fulltext
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812429

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