Interpretative Reading of The Antibiogram
Interpretative Reading of The Antibiogram
Interpretative Reading of The Antibiogram
antibiogram
Luis Martnez-Martnez
Service of Microbiology
University Hospital Marqus de Valdecilla
Santander, Spain
M
RA ANTIMICROBIAL
G
AGENT
BIO
TI
AN
C E Y TO
N LIT
A I PK XIC
IST TIB /P ITY
E S P D
R CE
U S
S
MICRO- VIRULENCE
ORGANISM MECHANISMS OF DEFENSE PATIENT
Automation and
expert systems
Interpretative
reading
Interpretative
criteria
Susceptibility testing
standardization
Relationship between
resistance and
therapeutic failure
Description of
mechanisms of resistance
Introduction into
clinical practice
Discovery of
antimicrobial agents
S-I-R
Clinical Categories
Phenotype - Resistance
S-I-R SOFTWARE
(Expert system)
Define Phenotype
- Common Phenotypes
- Unusual Phenotypes
- ImpossiblePhenotypes
Deduce Phenotype of
Resistance
Clinical Relevance of
the mechanism of
resistance
Deduce Biochemical
Mechanism of Resistance
CTX IMP
CAZ
IMP CAZ
CTX
AMP
AMP
Enterobacter cloacae
SHV-12 IN Enterobacter
Klebsiella pneumoniae
CMY-2
PBP2a CN
APH(2)-AAC(6)
-lactamR AminoglicosydeR
S. aureus
E
E DA DA E
DA
REP-PCR
REP-PCR pattern A B C D E
Isolates number 14 4 2 1 1
MIC nalidixic acid (mg/L) >256 (R) 8 (S) 8-16 (S) >256 (R) 32 (R)
MIC ciprofloxacin (mg/L) >32 (R) 0.38 (S) 2-4 (I/R) 3 (R) 1.5 (I)
Ser83Ile (14) None None Ser83Phe None
Mutations in gyrA
Asp87Asn (1)
Ser80Ile (2) Not None Not done None
Mutations in parC done
Not done (12)
Multifactorial multiresistance