Time to switch from CLSI to EUCAST? A Southeast Asian perspective

Cusack, Tomas-Paul; Ashley, Elizabeth A.; Ling, Clare; Roberts, Tamalee; Turner, Paul; Wangrangsimakul, Tri; Dance, David A. B.

doi:10.1016/j.cmi.2019.03.016

Cited by 26 publications

(27 citation statements)

References 7 publications

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“…11,12 In China, CR-KPN infections prevailed from 2.9% in 2005 to 40% in 2017 and the distribution differed greatly by region, with the lowest in northeast and the highest in eastern region of China. [13][14][15] Here, we investigated the distribution and drug resistance trends of K. pneumoniae causing UTIs in a tertiary teaching hospital from 2011 to 2019 to provide reference for rational use of antibiotics.…”

Section: Introductionmentioning

confidence: 99%

Resistance Trends of Klebsiella pneumoniae Causing Urinary Tract Infections in Chongqing, 2011–2019

Ding¹,

Wang²,

Pu³

et al. 2021

IDR

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Purpose To analyze the characteristics and trends of drug resistance for Klebsiella pneumoniae ( K. pneumoniae ), isolated from urinary tract infections (UTIs), to common antibiotics used in clinics. Methods This retrospective study was conducted in a teaching hospital in Chongqing from 2011 to 2019. Laboratory data of isolated bacteria were collected and analyzed. Results Among the 17,966 non-repetitive strains isolated from the urine sample, a total of 1543 K. pneumoniae isolates were identified, with an isolation frequency secondary only to Escherichia coli ( E. coli ) and there was a peak in the K. pneumoniae isolates in the year 2013. During the period, the rate of extended-spectrum β-lactamase (ESBL)-producing K. pneumoniae fell from 48.4% in 2011 to 32.9% in 2019, and a marked jump of resistance was seen in carbapenems from 2.2% to 18.0%. The peak of carbapenem resistance rate (22.6%) to K. pneumoniae was observed in 2017 along with a low ESBL-producing rate (30.9%). Piperacillin/tazobactam and cefepime resistance levels went up from 4.4% to 25.7% and from 18.2% to 30.5%, respectively. Moreover, the K. pneumoniae isolates resistance rate to carbapenems and amikacin gradually grew up, showing their peaks in 2017, and then dropped year by year. However, ceftazidime and aztreonam resistance levels were relatively stable, fluctuating between 21.8% and 35.6%, 32.2% and 39.4%, respectively. Conclusion There is a significant upward tendency in carbapenem resistance rate and a downward tendency in ESBL-production rate in K. pneumoniae isolates from UTIs, and continuous surveillance is necessary in the future.

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Section: Introductionmentioning

confidence: 99%

Resistance Trends of Klebsiella pneumoniae Causing Urinary Tract Infections in Chongqing, 2011–2019

Ding¹,

Wang²,

Pu³

et al. 2021

IDR

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“…Difficulties implementing EUCAST in resource-limited settings is especially hampered because defibrinated horse blood is not available for AST of fastidious bacteria. This has been published also by others and we recommend a low-resource adapted EUCAST version to overcome these obstacles (4,28).…”

Section: Discussionmentioning

confidence: 73%

Implementation of Automated Blood Culture With Quality Assurance in a Resource-Limited Setting

Laer

N'Guessan²,

Touré³

et al. 2021

Front. Med.

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Background: Blood cultures (BC) have a high clinical relevance and are a priority specimen for surveillance of antimicrobial resistance. Manual BC are still most frequently used in resource-limited settings. Data on automated BC performance in Africa are scarce. We implemented automated BC at a surveillance site of the African Network for improved Diagnostics, Epidemiology and Management of Common Infectious Agents (ANDEMIA).Methods: Between June 2017 and January 2018, pairs of automated BC (BacT/ALERT®FA Plus) and manual BC (brain-heart infusion broth) were compared at a University hospital in Bouaké, Côte d'Ivoire. BC were inoculated each with a target blood volume of 10 ml from the same venipuncture. Automated BC were incubated for up to 5 days, manual BC for up to 10 days. Terminal subcultures were performed for manual BC only. The two systems were compared regarding yield, contamination, and turnaround time. For quality assurance, isolates were retested in a German routine microbiological laboratory.Results: BC sampling was increased from on average 24 BC to 63 BC per month. A total of 337 matched pairs of BC were included. Automated BC was positive in 36.5%, manual BC in 24.0% (p-value < 0.01), proportion of contamination was 47.9 and 43.8%, respectively (p-value = 1.0). Turnaround time of positive BC was shortened by 2.5 days with automated compared to manual BC (p < 0.01). Most common detected pathogens in both systems were Klebsiella spp. (26.0%) and Staphylococcus aureus (18.2%). Most contaminants were members of the skin flora. Retesting of 162 isolates was concordant in 79.6% on family level.Conclusions: Implementing automated BC in a resource-limited setting is possible and improves microbiological diagnostic performance. Automated BC increased yield and shortened turnaround times. Regular training and mentorship of clinicians has to be intensified to increase number and quality of BC. Pre-analytical training to improve diagnostic stewardship is essential when implementing a new microbiological method. Retesting highlighted that manual identification and antimicrobial susceptibility testing can be of good quality and sustainable. The implementation of automated tools should be decided individually according to economic considerations, number of samples, stable supply chain of consumables, and technical sustainability.

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“…The most objectives of EUCAST are to harmonize antimicrobial breakpoints in Europe 38 and to act because the breakpoint committee for the EU Medicines Agency (EMEA) during the registration of latest antimicrobial agents, as defined in an exceedingly Standard procedure agreed between the EMEA, EUCAST and also the pharmaceutical industry in 2005 39 . The responsibility for the development of harmonized breakpoints rests with the Steering Committee along with consultation regarding the national breakpoint committees, the EUCAST General Committee, the susceptibility testing devices manufacturers, and the pharmaceutical industry 40 . The International Standards Organization (ISO) is currently developing a worldwide standard to see MICs by microdilution 41 .…”

Section: Eucast Guidelines: Eucast Is the European Committee On Antimicrobial Susceptibility Testingmentioning

confidence: 99%

Rast and Eucast in Blood Test- A Review

Brundha

Ezhilarasan

2020

IJFMT

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An allergic response is the hypersensitive immune response to a substance which is normally harmless or would not cause an immune response in everyone. An allergic response can cause several symptoms such as itching, inflammation and tissue injury. The manifestation of allergies is recognized in the form of urticaria, swelling, burning, pain, and dryness of the mucosa, stomatitis. radioallergosorbent test (RAST) which is the radioallergosorbent test used for the confirmation of allergic reaction in the body. This test specifically deals with the IgE antibodies which are responsible for the allergic reactions on the body. It is very essential to crosscheck the exact history related to allergy. Individual sensitivity and population sensitivity, both are equally responsible for skin allergy are the factors which are to be considered. Skin tests become negative under conditions of severe allergic reactions which is determined by graded therapy by freedom from contact and using epinephrine administration. RAST test is a two-stage procedure. RAST-test is performed according to the guidelines of European Committee on Antimicrobial Susceptibility (EUCAST). The reliability of the test is high compared to other skin tests. Specificity based on two radioallergosorbent tests is high as 90% for inhaled allergens. It shows excellent reproducibility across a full measuring range with the help of the calibration curve. The RAST test is considered to be extremely sensitive. It shows high specificity which binds to allergen-specific IgE. This article mainly deals with the RAST procedure, advantages and disadvantages of the test.

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Time to switch from CLSI to EUCAST? A Southeast Asian perspective

Cited by 26 publications

References 7 publications

Resistance Trends of Klebsiella pneumoniae Causing Urinary Tract Infections in Chongqing, 2011–2019

Resistance Trends of Klebsiella pneumoniae Causing Urinary Tract Infections in Chongqing, 2011–2019

Implementation of Automated Blood Culture With Quality Assurance in a Resource-Limited Setting

Rast and Eucast in Blood Test- A Review

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