Overview of CLSI,EUCAST,and Susceptibility Breakpoints in China

doi:10.13560/j.cnki.biotech.bull.1985.2022-0695

Abstract

Abstract:

The significance of establishing susceptibility breakpoints is to interpret the results of drug susceptibility tests,and to select appropriate drugs and optimal dosing regimens in treating animals,which is an important means to control drug resistance. At present,institutions to establish susceptibility breakpoints have been established in many developed countries,among which the most influential and authoritative institutions are the Clinical and Laboratory Standards Institute（CLSI）and the European Committee on Antimicrobial Susceptibility Testing（EUCAST）. The research on drug resistance monitoring in China started relatively late,and mainly drew on the susceptibility breakpoints established by the CLSI. In 2017,with the support of the European Society for Clinical Microbiology and Infectious Diseases and EUCAST,the Chinese Committee on Antimicrobial Susceptibility Testing was established in China. Leading by the China Institute of Veterinary Drug Control（IVDC）in recent years,researchers from various research institutions have also made breakthroughs in susceptibility breakpoints and drug resistance monitoring,laying a solid foundation for controlling the development of antimicrobial resistance in China. This article first introduced the definition and significance of susceptibility breakpoints to provide a basic understanding for microbiological researchers. Then,it reviewed the basic situation of the CLSI and the EUCAST,and compared the differences in the establishment of susceptibility breakpoints between the two. Finally,this article analyzed and summarized the results of China's veterinary antimicrobial resistance monitoring and susceptibility breakpoints. In general,China is in a state of steady growth in the control of veterinary antimicrobial resistance,and many established standards for the determination of resistance are of great significance for controlling the development of resistance. However,there are still many veterinary antibiotics lacking corresponding susceptibility breakpoints,which requires more researchers to find more rapid,simple and accurate methods in the future,and fill and update the susceptibility breakpoints of veterinary antibiotics.

Key words: veterinary antimicrobials, CLSI, EUCAST, breakpoint, difference

RUAN Zi-han, HUANG An-xiong, WANG Xiu-juan, HUANG Ling-li, HAO Hai-hong. Overview of CLSI,EUCAST,and Susceptibility Breakpoints in China[J]. Biotechnology Bulletin, 2022, 38(9): 47-58.

Figures/Tables 5

References 52

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委员会 Committee	职责 Responsibility	主要文件 Main documents
抗菌药物敏感性试验（AST）小组委员会Antimicrobial Susceptibility Testing（AST）Subcommittee	为实验室提供信息,使其为临床医生选择适当的抗菌治疗提供建议Provide the laboratory with information to advise the clinician on the choice of appropriate antimicrobial therapy	M100、M23、M11、M07、M02
抗真菌药物敏感性试验委员会Antifungal Susceptibility Testing Subcommittee	制定标准和指南,促进准确的抗真菌药物敏感性试验和适当的报告Develop standards and guidelines to facilitate accurate antifungal susceptibility testing and appropriate reporting	M54、M59、M60、M61
兽用抗菌药物敏感性试验（VAST）委员会Veterinary Antimicrobial Susceptibility Testing（VAST）	VAST小组委员会合作制定标准和指南,确保准确的抗菌药物敏感性试验和适当的报告The VAST subcommittee collaborated to develop standards and guidelines to ensure accurate antimicrobial susceptibility testing and appropriate reporting	VET01、VET01S、VET03

委员会 Committee	职责 Responsibility	主要文件 Main documents
抗菌药物敏感性试验（AST）小组委员会Antimicrobial Susceptibility Testing（AST）Subcommittee	为实验室提供信息,使其为临床医生选择适当的抗菌治疗提供建议Provide the laboratory with information to advise the clinician on the choice of appropriate antimicrobial therapy	M100、M23、M11、M07、M02
抗真菌药物敏感性试验委员会Antifungal Susceptibility Testing Subcommittee	制定标准和指南,促进准确的抗真菌药物敏感性试验和适当的报告Develop standards and guidelines to facilitate accurate antifungal susceptibility testing and appropriate reporting	M54、M59、M60、M61
兽用抗菌药物敏感性试验（VAST）委员会Veterinary Antimicrobial Susceptibility Testing（VAST）	VAST小组委员会合作制定标准和指南,确保准确的抗菌药物敏感性试验和适当的报告The VAST subcommittee collaborated to develop standards and guidelines to ensure accurate antimicrobial susceptibility testing and appropriate reporting	VET01、VET01S、VET03

抗菌药物类别 Class of antibiotics	抗菌药物 Antibiotic
氨基糖苷类Aminoglycosides	卡那霉素,阿米卡星,链霉素Kanamycin,Amikacin,Streptomycin
大环内酯类Macrolides	红霉素Erythromycin
叶酸途径抑制剂Folic acid pathway inhibitor	磺胺类药物、甲氧苄氨Sulfonamides,Trimethoprim
糖肽类Glycopeptides	万古霉素、替考拉宁Vancomycin,Teicoplanin
其他Others	氟苯尼考,呋喃妥因、黏菌素、夫西地酸、利福平、甲硝唑Flufenicol,Nitrofurantoin,Colistin,Fusidic Acid,Rifampicin,Metronidazole

抗菌药物类别 Class of antibiotics	抗菌药物 Antibiotic
氨基糖苷类Aminoglycosides	卡那霉素,阿米卡星,链霉素Kanamycin,Amikacin,Streptomycin
大环内酯类Macrolides	红霉素Erythromycin
叶酸途径抑制剂Folic acid pathway inhibitor	磺胺类药物、甲氧苄氨Sulfonamides,Trimethoprim
糖肽类Glycopeptides	万古霉素、替考拉宁Vancomycin,Teicoplanin
其他Others	氟苯尼考,呋喃妥因、黏菌素、夫西地酸、利福平、甲硝唑Flufenicol,Nitrofurantoin,Colistin,Fusidic Acid,Rifampicin,Metronidazole

微生物Microorganism	抗菌药物Antibacterial agent	MIC折点 MIC breakpoints/（μg·mL^-1）					抑菌圈直径折点Zone diameter breakpoints /mm
		CLSI			EUCAST		CLSI			EUCAST
		S≤	I	R≥	S≤	R>	S≥	I	R≤	S≥	R<
肠杆菌Enterobacterium	哌拉西林Iperacillin	16	32-64	128	8	8	17	14-16	16	20	20
	强力霉素Oxycycline	4	8	16	-	-	14	11-13	10	-	-
	左氧氟沙星Levofloxacin	0.12	0.25-1	2	0.5	1	-	-	-	23	19
葡萄球菌 Staphylococcus spp.	氧氟沙星Ofloxacin	1^a	2^a	4^a	0.001^b/0.001^c	1^b/1^c	21^a	16-20^a	21^a	50^b/50^c	21^b/24^c
葡萄球菌 Staphylococcus spp.	左氧氟沙星Levofloxacin	1^a	2^a	4^a	0.001 ^b/0.001^c	1^b/1^c	19^a	16-18^a	15^a	50^b/50^c	22^b/24^c
肺炎链球菌 Streptococcus neumoniae	左氧氟沙星Levofloxacin	2	4	8	0.001	2	17	14-16	13	50	16
肺炎链球菌 Streptococcus neumoniae	万古霉素Ancomycin	1	-	-	2	2	17	-	-	16	16
厌氧菌 Anaerobic bacteria	美罗培南Eropenem	4^d	8^d	16^d	1^e	1^e	NF	NF	NF	28^e	28^e
厌氧菌 Anaerobic bacteria	克林霉Clindamycin	2^d	4^d	8^d	4^e	4^e	NF	NF	NF	10^e	10^e