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Reading and understanding an antibiogram

Carlo Tascini, Emanuela Sozio, Bruno Viaggi, Simone Meini
  • Carlo Tascini
    First Division of Infectious Diseases, Cotugno Hospital, Azienda Ospedaliera dei Colli, Napoli, Italy | carlo.tascini@libero.it
  • Emanuela Sozio
    Department of Emergency Medicine, University-Hospital of Pisa, Italy
  • Bruno Viaggi
    Department of Neuroanesthesia and Intensive Care, Careggi University-Hospital, Firenze, Italy
  • Simone Meini
    Department of Internal Medicine, S.M. Annunziata Hospital, Firenze, Italy

Abstract

In recent years, we have been facing a significant increase in antimicrobial resistance and complex enzymatic mechanisms. The challenge of antibiotic resistance is becoming dramatic. Among gram-positive it is spreading resistance to glycopeptides, reducing the possibility to use these drugs empirically. Among gram-negative rods, beside the spreading of extended-spectrum β-lactamases, there is an increased diffusion of carbapenemases. In order to administer the correct antibiotic therapy, physicians need a rapid and correct interpretation with non-automated tests to implement appropriate therapeutic strategies. The automated reporting systems do not always provide complete and accurate information on antimicrobial resistance phenotype, making it difficult to interpret. Recently, the European Committee of Antimicrobial Susceptibility Testing (EUCAST) has proposed a new breakpoint system to be adopted by European countries. An interpretative reading of an antibiogram aims to analyze the overall susceptibility pattern, not just the result for an individual antibiotic, and so to predict the underlying resistance mechanisms. The purpose of this work is to guide physicians in reading and understanding antibiograms through an attempt of phenotypic interpretation of resistance mechanism.

Keywords

Antibiogram; susceptibility test; minimal inhibitory concentration; antibiotic.

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Submitted: 2016-10-06 16:00:44
Published: 2016-12-15 18:00:23
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Copyright (c) 2016 Carlo Tascini, Emanuela Sozio, Bruno Viaggi, Simone Meini

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