Publication: Effect of MIC interpretative breakpoint revision on cephalosporin and carbapenem susceptibility among ESBL-producing enterobacteriaceae
Issued Date
2012-10-01
Resource Type
ISSN
1875855X
19057415
19057415
Other identifier(s)
2-s2.0-84874594769
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Asian Biomedicine. Vol.6, No.5 (2012), 713-721
Suggested Citation
Pattarachai Kiratisin Effect of MIC interpretative breakpoint revision on cephalosporin and carbapenem susceptibility among ESBL-producing enterobacteriaceae. Asian Biomedicine. Vol.6, No.5 (2012), 713-721. doi:10.5372/1905-7415.0605.112 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/13599
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Effect of MIC interpretative breakpoint revision on cephalosporin and carbapenem susceptibility among ESBL-producing enterobacteriaceae
Author(s)
Other Contributor(s)
Abstract
Background: Minimum inhibitory concentration (MIC) breakpoints of selected cephalosporins and carbapenems against Enterobacteriaceae have been revised by major guidelines including CLSI and EUCAST mainly according to available pharmacokinetic/pharmacodynamic data. A decrease of breakpoint may obviate the need to detect specific resistance mechanisms such as extended-spectrum -lactamase (ESBL) and carbapenemase, which may be less correlated to treatment outcome than does the actual MIC of each agent. Objective: To analyze cephalosporin and carbapenem MIC distributions among ESBL-producing Enterobacteriaceae at a university hospital against revised interpretative breakpoints. Methods: MIC distributions of selected cephalosporins and carbapenems among 505 isolates of genotypically confirmed ESBL-producing Enterobacteriaceae were determined by E-testTM method and analyzed according to interpretative breakpoints comparing between CLSI and EUCAST guidelines. Results: ESBL-producing Enterobacteriaceae demonstrated a wide range of cephalosporin MIC (≥1 to ≤64). Up to 9.7% of isolates displayed MIC lower than a revised cephalosporin breakpoint. Most isolates remained susceptible to imipenem and meropenem while as high as 24.6% were not susceptible to ertapenem. Lowered breakpoints may result in a change in categorical interpretations. Conclusion: ESBL-producing isolates could be reported as susceptible to a cephalosporin with revised breakpoints although clinical use is uncertain. A higher proportion of isolates would be reported as nonsusceptible to cephalosporins or carbapenems with lowered breakpoints and thus increasing use of broadspectrum antimicrobial agents should be monitored.