In Vitro Activity of Colistin (Polymyxin E) Versus 2541 Pseudomonas aeruginosa Clinical Isolates Obtained From Patients in Canadian Hospitals: Results of the CANWARD Study, 2008–2014
Notice bibliographique
Résumé
Background. Clinicians have limited therapeutic options from which to choose for the treatment of infections caused by multidrug-resistant (MDR) Pseudomonas aeruginosa (MDR = non-susceptible to at least one antimicrobial from three or more different classes). Colistin, a polymyxin antimicrobial, is sometimes used as an agent of last resort. The purpose of this study was to evaluate the in vitro activity of colistin (polymyxin E) against a large collection of P. aeruginosa clinical isolates obtained from patients in Canadian hospitals (CANWARD, 2008 to 2014). Methods. From January 2008 to December 2014, inclusive, 10 to 15 sentinel hospitals across Canada submitted clinical isolates from patients attending ERs, medical and surgical wards, hospital clinics, and ICUs (CANWARD). Each center was asked to submit clinical isolates (consecutive, one per patient/infection site) from blood (100 to 240), respiratory (100 to 150), urine (25 to 100), and wound (25 to 100) infections. Susceptibility testing was performed using broth microdilution as described by CLSI. Results. The in vitro activity of colistin and comparator antimicrobials was evaluated versus 2541 P. aeruginosa clinical isolates (table below). Three-hundred and seventy-one isolates (14.6% of all isolates tested) were MDR. Of these, 92.2% were susceptible to colistin. Among 140 colistin non-susceptible isolates (5.5% of all isolates tested), 79.3% remained fully susceptible to antimicrobials from three or more antipseudomonal antimicrobial classes. Conclusion. Colistin demonstrated potent in vitro activity against P. aeruginosa clinical isolates, including those with an MDR phenotype. Isolates that were non-susceptible to colistin typically remained susceptible to multiple other antipseudomonal antimicrobials, indicating a lack of cross resistance. Disclosures. D. Hoban, Abbott: research relationship, Research support Achaogen: research relationship, Research support. Affinium: research relationship, Research support. AstraZeneca: research relationship, Research support. Astellas: research relationship, Research support. Cerexa: research relationship, Research support. Cubist: research relationship, Research support. Galderma: research relationship, Research support. Janssen Ortho Inc: research relationship, Research support. Merck: research relationship, Research support. Novexel: research relationship, Research support. Paladin Labs: research relationship, Research support. Pfizer: research relationship, Research support. Pharmascience Inc: research relationship, Research support. Sunovion: research relationship, Research support. Targanta: research relationship, Research support. Tetraphase: research relationship, Research support. The Medicines Company: research relationship, Research support. Theravance: research relationship, Research support. Wyeth: research relationship, Research support. Zoetis: research relationship, Research support; G. Zhanel, Abbott: research relationship, Research support. Achaogen: research relationship, Research support. Affinium: research relationship, Research support. Astellas: research relationship, Research support. AstraZeneca: research relationship, Research support. Cerexa: research relationship, Research support. Cubist: research relationship, Research support. Galderma: research relationship, Research support. Janssen Ortho Inc: research relationship, Research support. Merck: research relationship, Research support. Merck: research relationship, Research support. Novexel: research relationship, Research support. Paladin Labs: research relationship, Research support. Pfizer: research relationship, Research support. Pharmascience Inc: Research relationship, Research support. Sunovion: research relationship, Research support. Targanta: research relationship, Research support. Tetraphase: research relationship, Research support. The Medicines Company: research relationship, Research support. Theravance: research relationship, Research support. Wyeth: research relationship, Research support. Zoetis: research relationship, Research support
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».