Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance
Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance
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DOI：
10.1111/j.1469-0691.2011.03570.x
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发表时间：
2012-03-01
影响因子：
14.2
通讯作者：
Monnet, D. L.
中科院分区：
文献类型：
--
作者：
Magiorakos, A. -P.;Srinivasan, A.;Monnet, D. L.
医学文献中使用了对多药耐药(MDR)、广泛耐药(XDR)和潘格鲁耐药(PDR)细菌的许多不同定义，以表征与医疗保健相关的耐药细菌的不同耐药模式。一组国际专家通过欧洲疾病预防和控制中心(ECDC)和疾病控制和预防中心(CDC)的联合倡议聚集在一起，创建了一个标准化的国际术语，用来描述金黄色葡萄球菌、肠球菌、肠杆菌科(沙门氏菌和志贺氏菌除外)、铜绿假单胞菌和不动杆菌的获得性耐药谱，所有这些细菌都经常导致医疗保健相关感染，并容易产生多重耐药。为每一种细菌构建了具有流行病学意义的抗菌药类别。使用临床实验室标准研究所(CLSI)、欧洲抗菌素敏感性测试委员会(EUCAST)和美国食品和药物管理局(FDA)的文件和断点创建了建议用于抗菌素敏感性测试的抗菌剂类别清单。MDR定义为对三种或三种以上抗菌药物类别中的至少一种药物获得不敏感，XDR定义为除两种或更少抗菌药物类别外的至少一种药物不敏感(即细菌分离株仅对一种或两种药物敏感)，PDR定义为对所有抗菌药物类别中的所有药物不敏感。为了确保这些定义的正确应用，应对细菌分离物进行抗菌类别中的所有或几乎所有抗菌剂的测试，并应避免选择性报告和抑制结果。
Many different definitions for multidrug-resistant (MDR), extensively drug-resistant (XDR) and pandrug-resistant (PDR) bacteria are being used in the medical literature to characterize the different patterns of resistance found in healthcare-associated, antimicrobial-resistant bacteria. A group of international experts came together through a joint initiative by the European Centre for Disease Prevention and Control (ECDC) and the Centers for Disease Control and Prevention (CDC), to create a standardized international terminology with which to describe acquired resistance profiles in Staphylococcus aureus, Enterococcus spp., Enterobacteriaceae (other than Salmonella and Shigella), Pseudomonas aeruginosa and Acinetobacter spp., all bacteria often responsible for healthcare-associated infections and prone to multidrug resistance. Epidemiologically significant antimicrobial categories were constructed for each bacterium. Lists of antimicrobial categories proposed for antimicrobial susceptibility testing were created using documents and breakpoints from the Clinical Laboratory Standards Institute (CLSI), the European Committee on Antimicrobial Susceptibility Testing (EUCAST) and the United States Food and Drug Administration (FDA). MDR was defined as acquired non-susceptibility to at least one agent in three or more antimicrobial categories, XDR was defined as non-susceptibility to at least one agent in all but two or fewer antimicrobial categories (i.e. bacterial isolates remain susceptible to only one or two categories) and PDR was defined as non-susceptibility to all agents in all antimicrobial categories. To ensure correct application of these definitions, bacterial isolates should be tested against all or nearly all of the antimicrobial agents within the antimicrobial categories and selective reporting and suppression of results should be avoided.