动物源性细菌抗生素耐药判定标准的研究现状

抗生素在解决了许多细菌感染性疾病治疗问题的同时,其广泛不合理的应用以及细菌自身适应性的改变也加速了细菌耐药性的产生,对全球经济和公共健康带来严重危害。为了能够很好地监测细菌耐药性的变化和有效的指导临床用药,控制细菌的耐药性,建立细菌的耐药判定标准成为了一项具有实践意义的重要任务。建立耐药判定标准需要收集大量的信息,包括野生型细菌的最小抑菌浓度(minimal inhibitory concentration, MIC)分布,体外药效学和体内药动学的数据以及临床治疗相关的数据,主要包括野生型临界值、药效学临界值和临床临界值3个方面。本文综述了动物源性耐药判定标准的研究进展,总结了目前应用最广泛的两个折点制定组织美国临床实验室标准化协会(CLSI)和欧洲药敏实验标准化委员会(EUCAST)建立耐药判定标准的方法,为建立符合我国耐药现状的耐药判定标准提供理论基础。

Advances on the establishment of antimicrobial susceptibility breakpoints for bacteria of animal origin

When using antibiotics to treat infectious diseases, their inadequate exposure during treatment and the adaptive changes of bacteria accelerated the emergence of antimicrobial resistance, which brought serious threats to global economy and public health. To monitor the change of antimicrobial resistance, improve the clinical efficacy, and control the antimicrobial resistance, establishing susceptibility breakpoints are of great practical significance. The determination of susceptibility breakpoints was based on a large mass of data, including the MIC distribution of wild-type bacteria, in vitro and in vivo pharmacokinetic-pharmacodynamic data, and clinical outcome. It mainly included three aspects, wild type cutoff, pharmacodynamics cutoff, clinical cutoff. This review reviewed the advances on the establishment of antimicrobial susceptibility breakpoints for bacteria of animal origin and summarized the methods of establishing susceptibility breakpoints determined by CLSI and EUCAST, which provided theoretical basis for establishing susceptibility breakpoints in our