Expert Consensus on Polymyxin Antimicrobial Susceptibility Testing and Clinical Interpretation.

Qi Wen Yang; Xiao Ling MA; Fu Pin HU; Jing Zhang; Tong Wen Sun; Bai Yi Chen; Ying Chun XU; You Ning Liu

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Expert Consensus on Polymyxin Antimicrobial Susceptibility Testing and Clinical Interpretation.

Author: Qi Wen YANG ¹ ; Xiao Ling MA ² ; Fu Pin HU ³ ; Jing ZHANG ³ ; Tong Wen SUN ⁴ ; Bai Yi CHEN ⁵ ; Ying Chun XU ¹ ; You Ning LIU ⁶
Author Information

1. Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
2. Department of Laboratory Medicine, the First Affiliated Hospital, University of Science and Technology of China, Hefei 230001, China.
3. Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China.
4. General ICU, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China.
5. Department of Infectious Diseases, the First Affiliated Hospital, China Medical University, Shenyang 110001, China.
6. Department of Respiratory Medicine, the First Medical Center of PLA General Hospital, Beijing 100853, China.
Collective Name:China Medical Education Association;Expert Committee on Infectious Diseases, China Medical Education Association
Publication Type:Journal Article
From: Chinese Medical Sciences Journal 2021;36(1):1-16
CountryChina
Language:English
Abstract: The polymyxins are important antimicrobial agents against antibiotic-resistant gram-negative bacilli. In 2020, the Clinical and Laboratory Standards Institute modified the clinical breakpoints for polymyxin susceptibility test by eliminating the "susceptible" interpretive category, only reporting intermediate (≤2 mg/L) and resistant (≥4 mg/L). However, the European Committee on Antimicrobial Susceptibility Testing recommended the use of clinical breakpoints of ≤2 mg/L as susceptible and >2 mg/L as resistant. The first-line laboratorians and clinicians in China have been perplexed by the inconsistence of international polymyxin clinical breakpoints and discouraged by the difficulty of conducting polymyxin susceptibility testing. Therefore, it is urgently needed to make it clear for the laboratorians in China to know how to accurately carry out polymyxin susceptibility testing and standardize the interpretation of susceptibility testing results. To this end, the experts from relevant fields were convened to formulate this consensus statement on the testing and clinical interpretation of polymyxin susceptibility. Relevant recommendations are proposed accordingly for laboratorians and clinicians to streamline their daily work.