Results from the Survey of Antibiotic Resistance (SOAR) 2018–21 in India: data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints
Bibliographic record
Abstract
OBJECTIVES: Antibiotic susceptibility determination of community-acquired respiratory tract infection (CA-RTI) isolates of Streptococcus pneumoniae and Haemophilus influenzae were collected from India (2018-21). METHODS: MICs were determined by CLSI broth microdilution; susceptibility data were interpreted using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. RESULTS: S. pneumoniae (n = 177) and H. influenzae (n = 171) isolates were collected from four hospital laboratories and two private laboratories in India. Only 41.2% pneumococci were penicillin susceptible by CLSI oral/EUCAST low-dose breakpoints, but 94.4% were susceptible by EUCAST high-dose/CLSI IV breakpoints. Good activity (≥89.8%, CLSI or PK/PD breakpoints) was observed for amoxicillin, amoxicillin/clavulanic acid, cefotaxime, ceftriaxone, levofloxacin, and moxifloxacin. Cefdinir and second-generation cephalosporins were less active (27.7%-64.4%). Tetracyclines, macrolides and trimethoprim/sulfamethoxazole showed poor activity (18.6%-31.1%). EUCAST breakpoints indicated >90% susceptibility to high-dose ceftriaxone and penicillin, moxifloxacin and high-dose levofloxacin. Lower susceptibility to other cephalosporins and aminopenicillins was observed with EUCAST versus CLSI or PK/PD breakpoints. Most H. influenzae isolates (91.8%) were β-lactamase negative; 13 and 5 were β-lactamase-negative ampicillin-resistant following EUCAST and CLSI criteria, respectively. Antibiotic susceptibility was ≥84.8% (CLSI) for all antibiotics except trimethoprim/sulfamethoxazole (23.4%). Susceptibility by EUCAST was similar, except for cefuroxime (oral) with no susceptible isolates versus 95.3% by CLSI and ≤29.8% versus ≥85.4% for fluoroquinolones. CONCLUSIONS: Some therapeutic options against S. pneumoniae and H. influenzae from CA-RTI in India remain, but only ceftriaxone covers both bacterial species using both guidelines. Continued surveillance of antibiotic susceptibility is important to monitor changes and trends in susceptibilities and for guiding empiric therapy of CA-RTIs.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".