Canadian recommendations for laboratory interpretation of multiple or extensive drug resistance in clinical isolates of Enterobacteriaceae, Acinetobacter species and Pseudomonas aeruginosa

摘要

The goal of this document was to provide Canadian laboratories with a framework forconsistent reporting and monitoring of multidrug resistant organisms (MDRO) and extensivelydrug resistant organisms (XDRO) for common gram-negative pathogens. This is the fnal editionof the interim recommendations, which were modifed after one year of broad consultativereview. This edition represents a consensus of peer-reviewed information and was co-authoredby the Canadian Public Health Laboratory Network and the Canadian Association of ClinicalMicrobiology and Infectious Diseases. There are two main recommendations. The frstrecommendation provides standardized defnitions for MDRO and XDRO for gram-negativeorganisms in clinical specimens. These defnitions were limited to antibiotics that are commonlytested clinically and, to reduce ambiguity, resistance (rather than non-susceptibility) was used tocalculate drug resistance status. The second recommendation identifes the use of standardizedlaboratory reporting of organisms identifed as MDRO or XDRO. Through the broadconsultation, which included public health and infection prevention and control colleagues,these defnitions are ready to be applied for policy development. Both authoring organizationsintend to review these recommendations regularly as antibiotic resistance testing evolves inCanada.