Inappropriately high breakpoints have resulted in systematic false-susceptible AST results to anti-TB drugs. MIC, PK/PD and clinical outcome data should be combined when setting breakpoints to minimise the emergence and spread of antimicrobial resistance. https://bit.ly/3i43wb6Cite this article as: Antimycobacterial Susceptibility Testing Group. Updating the approaches to define susceptibility and resistance to anti-tuberculosis agents: implications for diagnosis and treatment. Eur

SUMMARY:The in vitro activity of linezolid was evaluated against 84 clinical isolates of Mycobacterium tuberculosis, including multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains, isolated from the center for tuberculosis research and treatment of the Chinese army. Linezolid showed excellent activity, with minimum inhibitory concentrations (MICs) of 0.125-0.5 mg/mL against all tested isolates. There were no differences in the MIC 50 and MIC 90 of linezolid between susceptible, isoniazidresistant, MDR, and XDR. Indeed, all of the groups displayed identical MIC 90 values of 0.25 mg/mL, which is lower than previously reported in similar studies. We conclude that linezolid may be a more effective drug against M. tuberculosis and may play an important role in treating drug-resistant tuberculosis in China.

In this study we investigated the prevalence of antimicrobial resistance in clinical isolates of Gram-negative bacteria obtained from intensive care units (ICUs) in the People's Liberation Army (PLA) 309 Hospital located in beijing, China. between 2007 and 2010, a total of 1949 isolates of Gram-negative bacteria were collected and tested using an antibiotic susceptibility assay. A marked decrease was observed in the susceptibility of Acinetobacter baumannii to imipenem and amikacin as compared to that described in a previous report in China. Similar results were obtained for Pseudomonas aeruginosa. However, imipenem and amikacin showed strong activity against Escherichia coli and Klebsiella pneumoniae. Overall, the high rates of antimicrobial resistance against ICU pathogens in our hospital indicated a critical condition in Beijing, China. Development of a national control and monitoring system by the government may be an ideal method to solve the present problem of managing infections due to Gram-negative bacterial pathogens.

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BackgroundCurrently, hematopoietic stem cell transplantation is still an essential treatment approach for leukemia. However, patients with leukemia often have weakened immune function, especially more seriously compromised cellular immune response, and appear to be at greater risk for tuberculosis infection during the transplantation process. We aimed to investigate the efficacy and safety of hematopoietic stem cell transplantation for the treatment of patients with leukemia accompanying active tuberculosis infection.Material/MethodsWe retrospectively analyzed records of 7 consecutive patients who were diagnosed with leukemia concomitant with active tuberculosis infection and who underwent hematopoietic stem cell transplantation in our hospital from January 2006 to December 2012.ResultsAmong these 7 patients (4 males and 3 females; median age: 38 years; range: 30–46 years), the mean duration of anti-TB treatment before transplantation was 3 months (range: 2–4.5 months). All patients acquired engraftment, with an implantation rate of 100%. After transplantation, the mean duration of anti-TB treatment was 12 months. All patients had response after receiving anti-TB treatment. One patient died of leukemia relapse 6 months after the transplantation, but no tuberculosis infection-related death was reported.ConclusionsPatients with leukemia concomitant with active tuberculosis infection can be treated with hematopoietic stem cell transplantation if they receive an effective anti-TB treatment regimen. The anti-TB treatment regimen had no effect against hematopoietic stem cell transplantation and was well-tolerated. All post-transplanted patients experienced no relapse of tuberculosis during the immune-suppression period. The findings in the present investigation deserve further in-depth study.