Changing MIC Breakpoints: Do Mechanisms Count
Changing MIC Breakpoints: Do Mechanisms Count Changing MIC Breakpoints: Do Mechanisms Count
Treatment of ESBL Positive Organisms with Cephalosporins MIC FAILURE DEATH 8 100% (6/6) 33% (2/6) 4 67% (2/3) 0% (0/3) 2 33% (1/3) 0% (0/3) ≤1 27% (3/11) 18% (2/11) (CLSI breakpoint 8 g/ml) Paterson, DL, et al. JCM 39: 2206 – 2212, 2001 10
New CLSI Guidelines 2010 • Problem with this approach Clinical studies show patients with “susceptible” MICs + ESBL fail therapy Inoculum used in bmd (10 5 ) too low and may dilute out resistant subpopulations giving false susceptible results 11
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Treatment of ESBL Positive<br />
Organisms with Cephalosporins<br />
<strong>MIC</strong> FAILURE DEATH<br />
8 100% (6/6) 33% (2/6)<br />
4 67% (2/3) 0% (0/3)<br />
2 33% (1/3) 0% (0/3)<br />
≤1 27% (3/11) 18% (2/11)<br />
(CLSI breakpoint 8 g/ml)<br />
Paterson, DL, et al. JCM 39: 2206 – 2212, 2001<br />
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