协和医学杂志

2020, v.11(05) 559-570

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多黏菌素药物敏感性检测及临床解读专家共识
Expert Consensus on Polymyxin Antimicrobial Susceptibility Testing and Clinical Interpretation

杨启文;马筱玲;胡付品;张菁;孙同文;陈佰义;徐英春;刘又宁;
YANG Qi-wen;MA Xiao-ling;HU Fu-pin;ZHANG Jing;SUN Tong-wen;CHEN Bai-yi;XU Ying-chun;LIU You-ning;Chinese Committee on Antimicrobial Susceptibility Testing,European Committee on Antimicrobial Susceptibility Testing,European Society of Clinical Microbiology and Infectious Diseases;Expert Committee on Infectious Diseases,China Medical Education Association;Department of Clinical Laboratory,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Depar

摘要(Abstract):

多黏菌素是耐药革兰阴性杆菌的重要治疗药物。2020年美国临床和实验室标准协会变更了多黏菌素药物敏感性折点,取消了多黏菌素敏感折点,仅报告中介(I≤2 mg/L)与耐药(R≥4 mg/L),而欧洲抗菌药物敏感性试验委员会则建议采用敏感(S≤2 mg/L)、耐药(R>2 mg/L)作为临床折点。多黏菌素药物敏感性试验的操作难度以及国际药物敏感性折点的不统一给国内临床实验室一线人员带来极大困扰。因此,如何精准开展多黏菌素药物敏感性检测,规范其报告解读是当前国内抗菌药物应用和抗感染领域亟待解决的问题。本共识对多黏菌素药物敏感性试验方法及结果进行规范解读,并提出相应建议。
Polymyxin was an important antimicrobial agent against resistant Gram-negative bacilli. In 2020, the American Clinical and Laboratory Standards Institute changed the clinical breakpoints of polymyxin, eliminating the "susceptible" interpretive category, and only reporting intermediate(I≤2 mg/L) and resistant(R≥4 mg/L) ones. However, the European Committee on Antimicrobial Susceptibility Testing recommended the use of susceptible(S≤2 mg/L), resistant(R>2 mg/L) as the clinical breakpoints. The international disunity of clinical breakpoints of polymyxin brings great trouble to the domestic clinical staffs. Therefore, how to accurately carry out the susceptibility test of polymyxin and standardize the interpretation of its report is an urgent problem to be solved in the field of antibacterial drug application and anti-infection in China. To this end, we organized experts in related fields to normalize and interpret the susceptibility test of polymyxin and its results, and put forward corresponding suggestions of experts for reference.

关键词(KeyWords): 多黏菌素;药物敏感性;临床解读;专家共识
polymyxin;drug sensitivity;clinical interpretation;expert consensus

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基金项目(Foundation): 国家重点研发计划“生物安全关键技术研发”重点专项(2018YFC1200100,2018YFC1200105);; 科技部“重大新药创制”科技重大专项资助项目(2017ZX09304005)~~

作者(Author): 杨启文;马筱玲;胡付品;张菁;孙同文;陈佰义;徐英春;刘又宁;
YANG Qi-wen;MA Xiao-ling;HU Fu-pin;ZHANG Jing;SUN Tong-wen;CHEN Bai-yi;XU Ying-chun;LIU You-ning;Chinese Committee on Antimicrobial Susceptibility Testing,European Committee on Antimicrobial Susceptibility Testing,European Society of Clinical Microbiology and Infectious Diseases;Expert Committee on Infectious Diseases,China Medical Education Association;Department of Clinical Laboratory,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Depar

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