The performance of antimicrobial susceptibility testing(AST)of bacteria and the interpretation of AST results for bacteria isolated from animals are complex tasks which must be performed using standard published metho...The performance of antimicrobial susceptibility testing(AST)of bacteria and the interpretation of AST results for bacteria isolated from animals are complex tasks which must be performed using standard published methodology and overseen by experts in clinical microbiology and in consultation with clinical pharmacologists.Otherwise,AST has significant potential for errors and mistakes.In this review,we provide guidance on how to correctly perform AST of bacteria isolated from animals and interpret the AST results.Particular emphasis is placed on the various approved or published methodologies for the different bacteria as well as the application of interpretive criteria,including clinical breakpoints and epidemiological cut-off values(ECVs/ECOFFs).Application of approved interpretive criteria and definitions of susceptible,susceptible dose-dependent,nonsusceptible,intermediate,and resistant for clinical breakpoints as well as wild-type and non-wildtype for ECVs,are explained and the difficulties resulting from the lack of approved clinical breakpoints for other bacteria,indications,and animal species is discussed.The requirement of quality controls in any AST approach is also emphasized.In addition,important parameters,often used in monitoring and surveillance studies,such as MIC50,MIC90,and testing range,are explained and criteria for the classification of bacteria as multidrug-resistant,extensively drug-resistant or pandrug-resistant are provided.Common mistakes are presented and the means to avoid them are described.To provide the most accurate AST,one must strictly adhere to approved standards or validated methodologies,like those of the Clinical and Laboratory Standards Institute or other internationally accepted AST documents and the detailed information provided therein.展开更多
副猪嗜血杆菌病是副猪嗜血杆菌主要针对保育仔猪的一种全身多发性的传染病,对猪场的危害极大。β-内酰胺类抗生素是临床上使用比较多的一类抗生素,具有杀菌活性强、毒性低、适应症广及临床疗效好等优点,常用于治疗副猪嗜血杆菌病,因此...副猪嗜血杆菌病是副猪嗜血杆菌主要针对保育仔猪的一种全身多发性的传染病,对猪场的危害极大。β-内酰胺类抗生素是临床上使用比较多的一类抗生素,具有杀菌活性强、毒性低、适应症广及临床疗效好等优点,常用于治疗副猪嗜血杆菌病,因此有必要了解副猪嗜血杆菌对β-内酰胺类抗生素的耐药情况,从而更科学地指导临床用药和新药开发。本研究参考CLSI-VET和VETCAST中流行病学临界值的建立方法,汇总不同地区来源的菌株对14种β-内酰胺类药物的药敏结果,建立β-内酰胺类药物的流行病学临界值。结果显示,头孢克洛、头孢吡肟、头孢噻肟、头孢喹肟、头孢噻呋、头孢氨苄、阿莫西林-克拉维酸、阿莫西林、克拉维酸、氨苄西林、青霉素、苯唑西林、亚胺培南和美罗培南的流行病学折点值分别为16、0.5、0.125、0.03125、0.5、32、0.25、1、0.5、1、2、8、0.25、0.0625μg·mL-1,可以得出副猪嗜血杆菌对氨苄西林、阿莫西林以及头孢吡肟的耐药率较高,对亚胺培南和阿莫西林-克拉维酸的敏感性较高。在CLSI(Clinical and Laboratory Standards Institute)和EUCAST(The European Committee on Antimicrobial Susceptibility Testing)缺乏敏感性评判标准的情况下,本研究可以直观地识别非野生型菌株的出现,有利于耐药性监测工作的开展,对副猪嗜血杆菌的治疗和防控具有一定的参考价值。展开更多
文摘The performance of antimicrobial susceptibility testing(AST)of bacteria and the interpretation of AST results for bacteria isolated from animals are complex tasks which must be performed using standard published methodology and overseen by experts in clinical microbiology and in consultation with clinical pharmacologists.Otherwise,AST has significant potential for errors and mistakes.In this review,we provide guidance on how to correctly perform AST of bacteria isolated from animals and interpret the AST results.Particular emphasis is placed on the various approved or published methodologies for the different bacteria as well as the application of interpretive criteria,including clinical breakpoints and epidemiological cut-off values(ECVs/ECOFFs).Application of approved interpretive criteria and definitions of susceptible,susceptible dose-dependent,nonsusceptible,intermediate,and resistant for clinical breakpoints as well as wild-type and non-wildtype for ECVs,are explained and the difficulties resulting from the lack of approved clinical breakpoints for other bacteria,indications,and animal species is discussed.The requirement of quality controls in any AST approach is also emphasized.In addition,important parameters,often used in monitoring and surveillance studies,such as MIC50,MIC90,and testing range,are explained and criteria for the classification of bacteria as multidrug-resistant,extensively drug-resistant or pandrug-resistant are provided.Common mistakes are presented and the means to avoid them are described.To provide the most accurate AST,one must strictly adhere to approved standards or validated methodologies,like those of the Clinical and Laboratory Standards Institute or other internationally accepted AST documents and the detailed information provided therein.
文摘副猪嗜血杆菌病是副猪嗜血杆菌主要针对保育仔猪的一种全身多发性的传染病,对猪场的危害极大。β-内酰胺类抗生素是临床上使用比较多的一类抗生素,具有杀菌活性强、毒性低、适应症广及临床疗效好等优点,常用于治疗副猪嗜血杆菌病,因此有必要了解副猪嗜血杆菌对β-内酰胺类抗生素的耐药情况,从而更科学地指导临床用药和新药开发。本研究参考CLSI-VET和VETCAST中流行病学临界值的建立方法,汇总不同地区来源的菌株对14种β-内酰胺类药物的药敏结果,建立β-内酰胺类药物的流行病学临界值。结果显示,头孢克洛、头孢吡肟、头孢噻肟、头孢喹肟、头孢噻呋、头孢氨苄、阿莫西林-克拉维酸、阿莫西林、克拉维酸、氨苄西林、青霉素、苯唑西林、亚胺培南和美罗培南的流行病学折点值分别为16、0.5、0.125、0.03125、0.5、32、0.25、1、0.5、1、2、8、0.25、0.0625μg·mL-1,可以得出副猪嗜血杆菌对氨苄西林、阿莫西林以及头孢吡肟的耐药率较高,对亚胺培南和阿莫西林-克拉维酸的敏感性较高。在CLSI(Clinical and Laboratory Standards Institute)和EUCAST(The European Committee on Antimicrobial Susceptibility Testing)缺乏敏感性评判标准的情况下,本研究可以直观地识别非野生型菌株的出现,有利于耐药性监测工作的开展,对副猪嗜血杆菌的治疗和防控具有一定的参考价值。
文摘目的探讨联合检测白细胞参数、白细胞介素-22(interleukin-22,IL-22)及脂蛋白相关磷脂酶A2(lipoprotein associated phospholipase A2,Lp-PLA2)对妊娠期糖尿病(gestational diabetes mellitus,GDM)的临床意义。方法选取2018年1月至2020年6月在廊坊市第四人民医院产前检查的孕妇106例,根据孕中期(24~28周)的口服糖耐量试验(oral glucose tolerance test,OGTT)结果分为观察组60例(血糖升高)和对照组46例(血糖正常)。收集2组孕妇年龄、孕前体重指数(body mass index,BMI)、血糖、血脂、稳态模型评估胰岛素抵抗指数(homeostasis model assessment-insulin resistance,HOMA-IR)等临床资料。比较两组孕早期(11~14周)白细胞计数(white blood cell count,WBC)、中性粒细胞百分比(percentage of neutrophils,Neut%)、淋巴细胞百分比(percentage of lymphocytes,LY%)、中性粒细胞计数与淋巴细胞计数的比值(the ratio of neutrophil count to lymphocyte count,NLR)、IL-22、LP-PLA2水平。使用Logistic回归法筛选GDM的危险因素。使用Logistic相关分析法分析相关指标与HOMA-IR的线性相关性。使用Pearson曲线分析相关指标对GDM的预测效力。结果观察组空腹血糖、服糖1 h后血糖、服糖2 h后血糖,TG,HOMA-IR、WBC、NLR、Lp-PLA2高于对照组,IL-22低于对照组(P<0.05)。Logistic分析结果显示,WBC、NLR、IL-22、Lp-PLA2为GDM发生的独立影响因素(P<0.05)。WBC、NLR、Lp-PLA2水平与HOMA-IR呈正相关(r=0.69,0.70,0.72,P<0.05),IL-22与HOMA-IR呈负相关(r=0.84,0.80,P<0.05)。WBC、NLR、IL-22、Lp-PLA2诊断GDM的最佳Cut-off值分别为≥9.23×10^(9)/L、≥4.06、≤7.68 pg/mL、≥230.96 ng/mL,单独诊断GDM的AUC分别为0.634、0.705、0.733、0.759,4项指标联合诊断的AUC为0.861,高于单一指标诊断的AUC。结论孕早期WBC、NLR、IL-22、Lp-PLA2水平与GDM的发生有关,联合检测有助于提高诊断的准确性。
