A Rapid Reporting System for Third-Generation Cephalosporin-Resistant Bacteria in Blood Culture Tests at Our Hospital and Its Clinical Utility

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  • 当院の血液培養検査における第３世代セファロスポリン系薬耐性菌の迅速報告体制と臨床的有用性
  • トウ イン ノ ケツエキ バイヨウ ケンサ ニ オケル ダイ3 セダイ セファロスポリンケイヤク タイセイキン ノ ジンソク ホウコク タイセイ ト リンショウテキ ユウヨウセイ

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Early detection of third-generation cephalosporin-resistant bacteria in blood culture tests influences the choice of antimicrobial agents. We report on our hospital’s system for early reporting of third-generation cephalosporin-resistant bacteria and its utility. The hospital operates a 24-h simple cefpodoxime (CPDX) testing system, where the content of a sample container with a positive blood culture result is smeared on a CA Sheep Blood Agar/VCM Chocolate EX II fractionation medium, and an antibiotic susceptibility test (AST) disk (Sensi-Disk CPDX) is placed at the center of the medium and incubated. The presence or absence of third-generation cephalosporin-resistant bacteria is estimated from the diameter of the growth inhibition zone. The physician in charge of AST makes comments on the chart based on the simple CPDX test results. The sensitivity of the simple CPDX test for detecting third-generation cephalosporin-resistant bacteria, based on AST results, was 95.5%. Among patients with failed antimicrobial therapy, the rate of switching antimicrobials before the AST results were known was 57.9% in cases where there were comments made by the physicians in charge of AST, compared with 42.9% in cases without comments. These results suggest that the simple CPDX test enables early and accurate detection of third-generation cephalosporin-resistant bacteria, facilitating early switching of antimicrobial agents through collaboration with physicians in charge of AST.

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