The impact of revised CLSI cefazolin breakpoints on the clinical outcomes of Escherichia coli bacteremia
| Autor: | Zhi-Yuan Shi, Chin-Fu Lin, Kung-Ching Wang, Meei-Fang Liu |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Male medicine.medical_specialty medicine.drug_class 030106 microbiology Cephalosporin Cefazolin Taiwan Bacteremia Microbial Sensitivity Tests urologic and male genital diseases medicine.disease_cause CLSI breakpoints 03 medical and health sciences Minimum inhibitory concentration Immunology and Microbiology(all) Internal medicine polycyclic compounds medicine Escherichia coli Immunology and Allergy Humans Dosing General hospital Escherichia coli Infections Aged Retrospective Studies General Immunology and Microbiology business.industry Septic shock organic chemicals General Medicine biochemical phenomena metabolism and nutrition Middle Aged bacterial infections and mycoses medicine.disease Surgery Anti-Bacterial Agents Infectious Diseases Female business medicine.drug |
| Zdroj: | Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi. 49(5) |
| ISSN: | 1995-9133 |
| Popis: | Background/Purpose The susceptibility breakpoints of cephalosporins for Enterobacteriaceae were revised by the Clinical and Laboratory Standards Institute (CLSI) in 2010 and 2011. The clinical outcome and susceptibility data were analyzed to evaluate the impact of revised CLSI cefazolin breakpoints on the treatment of Escherichia coli bacteremia. Methods Forty-three bacteremic Escherichia coli isolates from Taichung Veterans General Hospital, Taichung, Taiwan, during the period from January 2013 to December 2013, were selected to analyze the minimum inhibitory concentration (MIC) distributions of cefazolin and the correlated clinical responses to cefazolin therapy. Results The modal cefazolin MIC among the 43 isolates was 1 μg/mL and accounted for 18 (42%) isolates. The cumulative percentage for MICs ≤ 2 μg/mL was 79%. The conventional dosing regimens achieved clinical cure in 33 (97%) of 34 patients with bacteremia due to E. coli with a cefazolin MIC ≤ 2 μg/mL, in all of the six patients with a cefazolin MIC of 4 μg/mL, and all of the three patients with a cefazolin MIC of 8 μg/mL. Conclusion The microbiological data support the revised CLSI breakpoints of cefazolin. The conventional cefazolin dosing regimens can still achieve satisfactory clinical cure rates for bacteremia of E. coli with a cefazolin MIC ≤ 2 μg/mL in patients without severe septic shock. Before the approval of the efficacy of cefazolin for the treatment of E. coli isolates with a cefazolin MIC of 4 μg/mL, it is prudent to use cefazolin only when a high drug level can be achieved in the infection site, such as the urinary tract. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|