title: [The comparison of antibiotic susceptibilities of uropathogenic Escherichia coli isolates in transition from CLSI to EUCAST].
abstract: Determination of treatment protocols for infections according to antimicrobial susceptibility test (AST) results is are important for controlling the problem of antibiotic resistance. Two standards are widely used in the world. One of them is Clinical Laboratory Standards Institute (CLSI) standards used in Turkey for many years and the other is the European Committee on Antimicrobial Susceptibility Testing (EUCAST) standards which is used in European Union member countries and came into use in 2015 in Turkey. Since the EUCAST standards had higher clinical sensitivity limits particularly for gram-negative bacilli compared to CLSI (2009) standards, there will be some changes in antibiotic resistance profiles of Turkey with the use of EUCAST. CLSI has changed zone diameters after 2009 versions and the differences between the two standards were brought to a minimum level. Knowledge of local epidemiological data is important to determine empirical therapy which will be used in urinary tract infections (UTI). The aim of this study was to determine the differences of antibiotic susceptibility zone diameters based on our local epidemiological data among uropathogenic Escherichia coli isolates according to EUCAST 2014 and CLSI 2014 standards. A total of 298 E.coli strains isolated from urine samples as the cause of uncomplicated acute UTI agents, were included in the study. Isolates were identified by conventional methods and with BBL Crystal E/NF ID System (Becton Dickinson, USA). AST was performed with Kirby Bauer disk diffusion method and results were evaluated and interpreted according to the CLSI 2014 and EUCAST 2014 standards. According to the results, susceptibility rates of isolates against amikacin (100%) and trimethoprim-sulfamethoxazole (63.09%) were identical in both standards. However, statistically significant differences were observed between CLSI and EUCAST standards in terms of susceptibilities against gentamicin (91.95% and 84.56%, respectively; p= 0.004), cefuroxime axetil (20.13% and 77.18%, respectively; p= 0.000) and levofloxacin (73.83% and 67.11%, respectively; p= 0.044). No statistically differences between two standards for ampicillin (32.89% and 36.24%, respectively; p= 0.219), ampicillin-sulbactam (65.77% and 69.13%, respectively; p= 0.216), ciprofloxacin (72.48% and 71.14%, respectively; p= 0.392) and imipenem (94.63% and 95.30%, respectively; p= 0.426) were determined. In this transitional period, continuity of cooperation between the clinician and microbiology laboratory should be kept forefront and the maintenance of local surveillance studies should be provided by taking into account the changes in antibiotic susceptibility results.
authors.affiliation: Public Health Institution of Turkey, Department of Microbiology Reference Laboratory, Ankara, Turkey. serapsuzuk@gmail.com.
authors.forename: Serap
authors.initials: S
authors.lastname: Süzük
authors.forename: Banu
authors.initials: B
authors.lastname: Kaşkatepe
authors.forename: Havva
authors.initials: H
authors.lastname: Avcıküçük
authors.forename: Sebahat
authors.initials: S
authors.lastname: Aksaray
authors.forename: Ahmet
authors.initials: A
authors.lastname: Başustaoğlu
mesh_terms: D000583:Amikacin / Q000494:pharmacology; D000667:Ampicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001437:Bacteriuria / Q000382:microbiology; D002444:Cefuroxime / Q000494:pharmacology; D002939:Ciprofloxacin / Q000494:pharmacology; D052978:Disk Diffusion Antimicrobial Tests; D024881:Drug Resistance, Bacterial; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000382:microbiology; D005062:European Union; D005839:Gentamicins / Q000494:pharmacology; D006801:Humans; D015378:Imipenem / Q000494:pharmacology; D064704:Levofloxacin / Q000494:pharmacology; D008826:Microbial Sensitivity Tests / Q000379:methods / Q000592:standards*; D012015:Reference Standards; D013407:Sulbactam / Q000494:pharmacology; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology; D014421:Turkey; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000382:microbiology; D056689:Uropathogenic Escherichia coli / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D002939:Ciprofloxacin; C035444:sultamicillin; D064704:Levofloxacin; D015378:Imipenem; D000667:Ampicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D000583:Amikacin; D002444:Cefuroxime; D013407:Sulbactam