Inappropriate use and overuse of antibiotics are among the most important factors in resistance development, and effective antibiotic stewardship measures are needed to optimize outcomes. Selection of appropriate antimicrobials relies on accurate and timely antimicrobial susceptibility testing. However, the availability of clinical breakpoints and in vitro susceptibility testing often lags behind regulatory approval by several years for new antimicrobials. A Working Group of clinical/medical microbiologists from Brazil, Canada, Mexico, Saudi Arabia, Russia and the UK recently examined issues surrounding antimicrobial susceptibility testing for novel antibiotics. While commercially available tests are being developed, potential surrogate antibiotics may be used as marker of susceptibility. Using tedizolid as an example of a new antibiotic, this special report makes recommendations to optimize routine susceptibility reporting.
Проблема формирования MDR (multy-drug-resistant) штаммов Аcinetobacter baumannii и распространения резистентности в клинике чрезвычайно актуальна для онкологических стационаров. Для грамотной организации мероприятий по прерыванию путей передачи инфекции в стационаре и распространения внутрибольничных патогенов важно определение идентичности циркулирующих штаммов микроорганизмов. Оценка истинных филогенетических отношений изучаемых штаммов возможна с помощью проведения кластерного анализа изолятов с последующим построением и анализом MSP Dendrogram в системе MALDI-TOF BIOTYPER.
The aim of the study was to determine the main Candida species isolated from blood of cancer patients, to compare the taxonomic structure of strains obtained from children and adults with candidemia. In total, during the study period, candidemia was microbiologically proven by blood culture in 81 patients (duplicates were excluded). Patients in the intensive care unit (ICU) accounted for 35,8%. The total number of isolates elaborated was 82 strains of 10 Candida species. In general, in the taxonomic structure of candidemias, C. parapsilosis (61.0%) predominates, C. albicans (20.7%) is in the second place, followed by C. glabrata and C. lusitaniae (3.7% each); C. krusei, C. guilliermondii and C. tropicalis (2.4% each). C. parapsilosis was statistically significantly often isolated from blood compared to C. albicans (61.0% versus 20.7%, respectively, p<0.0001). Candidemia was statistically significantly more often detected in adults than in children (63.0% versus 37.0%, respectively, p<0.002). Moreover, in adults, C. parapsilosis was statistically significantly more often isolated from blood than C. albicans (70.6% versus 15.7%, respectively, p<0.0001). In children, there were no significant differences in the frequency of isolation of C. parapsilosis and C. albicans: the proportion of C. parapsilosis was 45.2%, C. albicans - 29.0%. Rare species were identified in 7.8% of cases in adults, and in 12.9% of cases in children without statistical difference (p>0.05). The proportion of Candida non-albicans during the study period was 79.3%, and C. parapsilosis is the main species in this group (76.9%).
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