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JYMS : Journal of Yeungnam Medical Science

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Review
Interpretation of Antimicrobial Susceptibility Test According to Resistance Mechanism of beta-lactam in Enterobacteriacae.
Chae Hoon Lee
Yeungnam Univ J Med. 2010;27(1):8-17.   Published online June 30, 2010
DOI: https://doi.org/10.12701/yujm.2010.27.1.8
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AbstractAbstract PDF
It is important to select appropriate antimicrobials for the treatment of infection according to the results of antimicrobial susceptibility tests (ASTs), yet the clinical isolates are sometimes susceptible to antibiotics that are clinically ineffective or this is due to technical error of the ASTs. So, interpretive reading of ASTs is needed and especially for the beta-lactams for treating Enterobacteriacae. This review describes the interpretive reading of ASTs according to natural antimicrobial resistance and the mechanisms of mechanisms, with giving special attention to the antibiotics phenotypes for Enterobacteriacae. Further, as all the diffent tissues have a different antimicrobial concentration for identical antimicrobials, more information is needed on the antimicrobial tissue distribution for the appropriate treatment of infection. (ED note: I hope you send me the paper.)
Original Articles
Interpretation of Antibiotics Susceptibility Test According to Antimicrobial Concentration in Tissues
Chae Hoon Lee, Hee Soon Cho
Yeungnam Univ J Med. 2007;24(2 Suppl):S430-442.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2S.S430
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AbstractAbstract PDF
Background
:It is important to select appropriate antimicrobials for the treatment of infection according to the results of antibiotic susceptibility test(AST). AST interprets as susceptible, resistant or intermediate on the base of breakpoints of Clinical and Laboratory Standard Institute(CLSI), but do not take into account the antimicrobial concentrations of variable tissues. As different tissues have different distributions of antimicrobials, it is necessary to interpret AST according to the tissue concentration. Thereby we intend to evaluate the usefulness of interpretation of antimicrobial susceptibility depending on tissue distribution of antimicrobials. Materials and Methods:Gram negative bacilli that isolated from clinical specimens in Yeungnam University Hospital from August to September, 2007 were evaluated retrospectively. The data of blood concentration and tissue distribution of antibiotics with variable administration route and dosage were collected and arranged in the forms of previous reported data and regarded as resistant if minimal inhibitory concentration (MIC) is higher than the expected concentration of each tissues.
Results
:Among the data reported as susceptible, aztreonam, imipenem and ciprofloxacin were relatively good relationship with AST. But, ampicillin, ticarcillin, cefazolin and cefotaxime of sputum or bronchial secretion were less effective with high MIC of organism. Gentamicin and amikacin also were shown as less effective in respiratory tissues and wound with high MIC of oganism.
Conclusion
:As different tissues have different antimicrobial concentrations for identical antimicrobial, more informations on antimicrobial tissue distribution is needed for appropriate treatment in infection. Reporting of MIC should be considered for selection of antimicrobials rather than AST with breakpoints. Therefore interpretation of AST considering tissue concentration is more helpful for prevention of major error and control of infection.
Comparison of the E-test with agar dilution susceptibility test by using bacteroides fragilis.
Hee Sun Kim, Sung Kwang Kim, Hwa Sun Cha
Yeungnam Univ J Med. 1993;10(1):135-143.   Published online June 30, 1993
DOI: https://doi.org/10.12701/yujm.1993.10.1.135
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AbstractAbstract PDF
The susceptibilities of 45 clinical isolates of bacteroidis fragilis to cefaclor, ciproflxacin and imipenem were determined by new method, E-test (AB Bidisk, Solna, Sweden) and were compared with those from conventional agar dilution method by using brain heart infusion, Mueller-Hinton and Wilk:..s Chalgren agar plates. And the susceptibility of 60 clinical isolates of bacteroides fragilis group (B. fragilis 45 strains, B. distasonis 6 strains, B. ovatus 5 strains, B. thetaiotaomicron 4 strains) to 5 quinolones (ciprofloxacin, enoxacin, norfloxacin, ofloxacin, pefloxacin) were determined by in vitro agar dilution method. Compared with agar dilution MICs for B. fragilis 45 strains, 90.3% of E-test MICs were within +/- 1 dilution of the agar dilutions, and 98.4% were within 2 dilutions. And there were little effect of different medium bases to determine MICs except Mueller-Hinton agar. On Mueller-Hinton agar, B. fragilis showed have or no growth activity. In vitro susceptibility of B. fragilis group to quinolones, most of the test strains showed resistant patterns to quinolones except ofloxacin and there was little difference of susceptibility patterns between species of B. fragilis group.

JYMS : Journal of Yeungnam Medical Science
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