Laboratory issues in the detection and reporting of antibacterial resistance

J. H. Jorgensen

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

A task of increasing importance for the clinical microbiology laboratory is the detection of antimicrobial resistance among bacterial isolates from individuals with both life-threatening and localized bacterial infections. The goal of an antimicrobial susceptibility test is to detect acquired resistance or to measure the degree of susceptibility of an isolate in an effort to assure the likelihood of successful chemotherapy of a patient's infection. Clinically important resistance has emerged recently among several bacterial groups and species, for example, vancomycin and high-level aminoglycoside resistance among Enterococcus species, penicillin and multi-drug resistance among Streptococcus pneumoniae, and beta-lactamase-mediated resistance among several members of the family Enterobacteriaceae. Fortunately, some important bacterial pathogens have not yet developed resistance and thus continue to be responsive to empiric therapeutic drug regimens, for example, penicillin therapy for beta-hemolytic streptococcal infections, and macrolide therapy of legionellosis. Susceptibility testing is most important with the common bacterial pathogens that are not predictably susceptible to drugs of choice because of acquired resistance mechanisms, for example, members of the family Enterobacteriaceae, Pseudomonas spp, Staphylococcus spp, Enterococcus spp, Haemophilus influenzae, Neisseria gonorrhoeae, Streptococcus pneumoniae, and certain viridans group streptococci. This article will review currently available methods for antibacterial susceptibility testing and discuss the strengths and weaknesses of the various approaches.

Original languageEnglish (US)
Pages (from-to)785-802
Number of pages18
JournalInfectious disease clinics of North America
Volume11
Issue number4
DOIs
StatePublished - Jan 1 1997

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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