Chinese Medical Sciences Journal ›› 2021, Vol. 36 ›› Issue (1): 1-16.doi: 10.24920/003864

• Guideline & Consensus •     Next Articles

Expert Consensus on Polymyxin Antimicrobial Susceptibility Testing and Clinical Interpretation

Qiwen Yang1, Xiaoling Ma2, Fupin Hu3, Jing Zhang3, Tongwen Sun4, Baiyi Chen5, Yingchun Xu1, *(), Youning Liu6, *(), China Medical Education Association , Expert Committee on Infectious Diseases, China Medical Education Association   

  1. 1Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
    2Department of Laboratory Medicine, the First Affiliated Hospital, University of Science and Technology of China, Hefei 230001, China
    3Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China
    4General ICU, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
    5Department of Infectious Diseases, the First Affiliated Hospital, China Medical University, Shenyang 110001, China
    6Department of Respiratory Medicine, the First Medical Center of PLA General Hospital, Beijing 100853, China
  • Received:2020-12-10 Accepted:2020-12-14 Published:2021-01-14 Online:2021-01-14
  • Contact: Yingchun Xu,Youning Liu E-mail:xycpumch@139.com;liuyn301@126.com
To address the inconsistence of international polymyxin clinical breakpoints, experts from Chinese Committee on Antimicrobial Susceptibility Testing and Expert Committee on Infectious Diseases China Medical Education Association were convened to formulate this consensus statement on the testing and clinical interpretation of polymyxin susceptibility. Relevant recommendations are proposed accordingly for laboratorians and clinicians to streamline their daily work.

The polymyxins are important antimicrobial agents against antibiotic-resistant gram-negative bacilli. In 2020, the Clinical and Laboratory Standards Institute modified the clinical breakpoints for polymyxin susceptibility test by eliminating the “susceptible” interpretive category, only reporting intermediate (≤2 mg/L) and resistant (≥4 mg/L). However, the European Committee on Antimicrobial Susceptibility Testing recommended the use of clinical breakpoints of ≤2 mg/L as susceptible and >2 mg/L as resistant. The first-line laboratorians and clinicians in China have been perplexed by the inconsistence of international polymyxin clinical breakpoints and discouraged by the difficulty of conducting polymyxin susceptibility testing. Therefore, it is urgently needed to make it clear for the laboratorians in China to know how to accurately carry out polymyxin susceptibility testing and standardize the interpretation of susceptibility testing results. To this end, the experts from relevant fields were convened to formulate this consensus statement on the testing and clinical interpretation of polymyxin susceptibility. Relevant recommendations are proposed accordingly for laboratorians and clinicians to streamline their daily work.

Key words: polymyxin, antimicrobial susceptibility testing, clinical interpretation, expert consensus

Article information: This article was first published in Chinese on Medical Journal of Peking Union Medical College Hospital 2020; 11(5): 559-570. 

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