Cystic fibrosis (CF) acute pulmonary exacerbations are often caused by Pseudomonas aeruginosa, including multi-drug resistant strains. Optimal antibiotic therapy is required to return lung function and should be guided by in vitro susceptibility results. There are sparse data describing ETEST performance for CF isolates using contemporary isolates, methods and interpretation, as well as novel antibiotics, such as ceftazidime–avibactam and ceftolozane–tazobactam. Pseudomonas aeruginosa (n = 105) isolated during pulmonary exacerbation from patients with CF were acquired from 3 US hospitals. Minimum inhibitory concentrations (MICs) were assessed by reference broth microdilution (BMD) and ETEST for aztreonam, cefepime, ceftazidime, ceftazidime–avibactam, ceftolozane–tazobactam, ciprofloxacin, levofloxacin, meropenem, piperacillin–tazobactam, and tobramycin. Broth microdilution was conducted in concordance with the Clinical and Laboratory Standards Institute M100. ETEST methodology reflected package insert recommendations. Performance of ETEST strips was evaluated using the Food and Drug Administration (FDA) and Susceptibility Testing Manufacturers Association (STMA) guidance. Of the 105 P. aeruginosa included, 46% had a mucoid phenotype. ETEST MICs typically read 0–1 dilution higher than BMD for all drugs. Categorical agreement and essential agreement ranged from 64 to 93% and 63 to 86%, respectively. The majority of observed errors were minor. A single very major error occurred with ceftazidime (4.2%). For ceftazidime–vibactam, 2 very major errors were observed and both were within essential agreement. Major errors occurred for aztreonam (3.3%), cefepime (9.4%), ceftazidime–avibactam (5.3%, adjusted 2.1%), ceftolozane–tazobactam (1%), meropenem (3.3%), piperacillin–tazobactam (2.9%), and tobramycin (1.5%). ETEST methods performed conservatively for most antibiotics against this challenging collection of P. aeruginosa from patients with CF.

中文翻译：

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ETEST 对囊性纤维化患者铜绿假单胞菌抗生素敏感性和最低抑菌浓度一致性的现代分析

囊性纤维化 (CF) 急性肺部恶化通常由铜绿假单胞菌引起，包括多重耐药菌株。需要最佳抗生素治疗来恢复肺功能，并应以体外药敏结果为指导。使用现代分离株、方法和解释以及新型抗生素（如头孢他啶-阿维巴坦和头孢洛扎烷-他唑巴坦）描述 CF 分离株 ETEST 性能的数据很少。在 CF 患者肺部恶化期间分离出的铜绿假单胞菌 (n = 105) 来自 3 家美国医院。通过参考肉汤微量稀释 (BMD) 和 ETEST 评估氨​​曲南、头孢吡肟、头孢他啶、头孢他啶-阿维巴坦、头孢唑烷-他唑巴坦、环丙沙星、左氧氟沙星、美罗培南、哌拉西林-他唑巴坦、和妥布霉素。根据临床和实验室标准协会 M100 进行肉汤微量稀释。ETEST 方法反映了包装说明书的建议。ETEST 试纸的性能根据食品和药物管理局 (FDA) 和敏感性测试制造商协会 (STMA) 指南进行评估。在包括的 105 种铜绿假单胞菌中，46% 具有粘液表型。所有药物的 ETEST MIC 读数通常比 BMD 高 0-1 倍。分类一致和基本一致的范围分别为 64% 至 93% 和 63% 至 86%。大多数观察到的错误是轻微的。头孢他啶 (4.2%) 出现了一个非常严重的错误。对于头孢他啶-维巴坦，观察到 2 个非常严重的错误，两者都在基本一致范围内。氨曲南 (3.3%)、头孢吡肟 (9.4%)、头孢他啶-阿维巴坦（5.3%，调整后的 2.1%）、头孢唑烷-他唑巴坦（1%）、美罗培南（3.3%）、哌拉西林-他唑巴坦（2.9%）和妥布霉素（1.5%）。ETEST 方法对大多数抗生素进行了保守的处理，以对抗来自 CF 患者的这种具有挑战性的铜绿假单胞菌。