JAC Advance Access published online on November 1, 2002
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkf225
© 2002 by The British Society for Antimicrobial Chemotherapy
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Original Paper
1 Department of Infection, Guy's, King's
and St Thomas' School of Medicine, St Thomas' Hospital,
London SE1 7EH, UK
* Corresponding author. E-mail: kevin.shannon{at}kcl.ac.uk.
Received 30 April 2002
; revised 9 August 2002
; accepted 28 August 2002
Objective: A recently proposed guideline
from the NCCLS recommends that results only from the first isolate
of a species per patient be used in calculation of percentage susceptibilities
to antimicrobial agents. Because this is apparently based on the
comparison of various calculation methods for results for oxacillin
against a fairly small number of isolates of Staphylococcus aureus,
we have applied these methods to a wider range of antibiotic/organism
combinations. Methods: Antibiotic susceptibility results from
our hospital laboratory database were analysed. Rates of antimicrobial
susceptibility were calculated using the various criteria proposed
by the NCCLS, including exclusion of results from duplicate isolates
and surveillance specimens from the calculations. Results and conclusion: Analysis of results
for methicillin against S. aureus,
gentamicin against Klebsiella spp., vancomycin
against enterococci (all in-patient specimens), and amoxicillin
and cefuroxime against Escherichia coli (general
practice specimens) confirm that, if duplicates and surveillance
specimens are excluded, results obtained with the various patient-
and episode-based methods for the calculation of percentage susceptibility
are very similar. Because of its simplicity and unambiguity, we
agree with the suggestion of the NCCLS group that results for the ‘first
isolate of a given species per patient per analysis period, irrespective
of body site, antimicrobial susceptibility profile or other phenotypic
characteristics' should be used in the calculation of susceptibility
frequencies.
Keywords: susceptibility frequencies, NCCLS proposal
Validation of the NCCLS proposal to use results
only from the first isolate of a species per patient in the calculation
of susceptibility frequencies
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