Comparison of antimicrobial susceptibility interpretation among Enterobacteriaceae using CLSI and EUCAST breakpoints
Abstract
PURPOSE: To determine the difference in antimicrobial susceptibility of various antibiotics using the CLSI & EUCAST breakpoints.
METHODS: In this non interventional, retrospective observational study, we reviewed minimum inhibitory concentrations (MIC) of various antibiotics routinely reported for Enterobacteriaceae clinical isolates, from an automated microbiology identification system (VITEK-2). These MICs were then analysed using both CLSI 2019 and EUCAST 2019 guidelines and classified as per the breakpoints into various categories.
RESULTS: The concordance rates of the antimicrobial susceptibility for various drugs ranged from 78.2% to 100% among two breakpoints. Perfect agreement with κ = 1 (p < 0.001) was observed for only three antimicrobials ceftriaxone, levofloxacin and trimethoprim-sulfamethoxazole. The changes in antimicrobial susceptibility interpretation for cefepime, ciprofloxacin, amoxicillin clavulanic acid was majorly in Intermediate category.
CONCLUSION: The change in interpretation of the susceptibility will lead to change in the usage of antibiotics especially due to recent change in definition of I by EUCAST. There is need of more studies in this aspect to ascertain clinical implication of change in antimicrobial susceptibility.
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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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