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Reading and understanding an antibiogram

机译:阅读和理解抗菌素

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In recent years, we have been facing a significant increase in antimicrobial resistance and complex enzymatic mechanisms. The challenge of antibiotic resistance is becoming dramatic. Among gram-positive it is spreading resistance to glycopeptides, reducing the possibility to use these drugs empirically. Among gram-negative rods, beside the spreading of extended-spectrum β -lactamases, there is an increased diffusion of carbapenemases. In order to administer the correct antibiotic therapy, physicians need a rapid and correct interpretation with non-automated tests to implement appropriate therapeutic strategies. The automated reporting systems do not always provide complete and accurate information on antimicrobial resistance phenotype, making it difficult to interpret. Recently, the European Committee of Antimicrobial Susceptibility Testing (EUCAST) has proposed a new breakpoint system to be adopted by European countries. An interpretative reading of an antibiogram aims to analyze the overall susceptibility pattern, not just the result for an individual antibiotic, and so to predict the underlying resistance mechanisms. The purpose of this work is to guide physicians in reading and understanding antibiograms through an attempt of phenotypic interpretation of resistance mechanism.
机译:近年来,我们已经面临着抗菌素耐药性和复杂的酶机制的显着增加。抗生素抗性的挑战变得日益严峻。在革兰氏阳性中,它正在传播对糖肽的耐药性,从而减少了凭经验使用这些药物的可能性。在革兰氏阴性杆菌中,除了广谱β-内酰胺酶的扩散外,碳青霉烯酶的扩散也有所增加。为了实施正确的抗生素治疗,医生需要对非自动化测试进行快速正确的解释,以实施适当的治疗策略。自动化报告系统并不总是提供有关抗菌素耐药性表型的完整而准确的信息,因此很难解释。最近,欧洲抗菌药物敏感性测试委员会(EUCAST)提出了一种新的断点系统,供欧洲国家采用。解释性读图的目的是分析整体药敏模式,而不仅仅是分析单个抗生素的结果,从而预测潜在的耐药机制。这项工作的目的是通过尝试对耐药机制进行表型解释来指导医生阅读和理解抗生素。

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