Work

P19 Impact of the introduction of the EUCAST 2020 susceptibility interpretation rules for Pseudomonas aeruginosa on selection of antibiotic therapy

Year: 2024

Type: conference-abstract

Abstract: Background In 2020, EUCAST changed the interpretation of WT Pseudomonas aeruginosa susceptibility to the first-line agents ciprofloxacin, piperacillin/tazobactam and ceftazidime from susceptible (S) to susceptible, increased exposure (I). The breakpoint changes were implemented at Cambridge University Hospitals (CUH) in March 2020, initially with no explanatory notes, and from June 2020 with the addition of an interpretative comment. Objectives To study the impact of implementing the EUCAST susceptibility interpretation of WT P. aeruginosa on carbapenem prescribing at CUH. Methods In this service evaluation, we analysed all clinical isolates of P. aeruginosa between 1 January 2020 and 30 September 2020. Only WT (fully susceptible isolates) were included. We retrospectively collected epidemiological data, clinical background, treatment information and Microbiology involvement and analysed this data to identify prescription rates and factors influencing meropenem prescription in P. aeruginosa infections, comparing three periods: Period 1 (pre-transition), Period 2 (transition) and Period 3 (post-transition). Results In total, 104 patients were included in the study. Meropenem use across all three periods was similar (17.6%, 18.4% and 12.5%, P=.799). Selective susceptibility reporting of meropenem susceptibility differed between periods, with a transient increase in reporting during period 2 (11.8%, 36.1% and 6.3%, respectively [P=.004]). Reporting of susceptibility to meropenem was associated with increased odds of meropenem prescribing (OR 4.3, 95% CI 1.40–13.7, P=.011). Conclusions The changes to the EUCAST breakpoints for P. aeruginosa did not have a significant impact on carbapenem prescription at CUH. This in part could be explained by selective susceptibility reporting of results.

Source: JAC-Antimicrobial Resistance

DOI: 10.1093/jacamr/dlae136.023

Authors: Chai Feng Benjamin Chan, Jumoke Sule, Theodore Gouliouris

Institutions: University of Cambridge, Cambridge University Hospitals NHS Foundation Trust

Language: English

Topic: Antibiotic Use and Resistance

Subfield: Applied Microbiology and Biotechnology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,781