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Legionella antibiotic susceptibility testing: is it time for international standardization and evidence-based guidance?

Portal, Edward, Descours, Ghislaine, Ginevra, Christophe, Mentasti, Massimo, Afshar, Baharak, Chand, Meera, Day, Jessica, Echahidi, Fedoua, Franzin, Laura, Gaia, Valeria, Lück, Christian, Meghraoui, Alaeddine, Moran-Gilad, Jacob, Ricci, Maria Luisa, Lina, Gerard, Uldum, Søren, Winchell, Jonas, Howe, Robin, Bernard, Kathryn, Spiller, Owen B., Chalker, Victoria J., Jarraud, Sophie, Ahlen, Catherine, Hashmi, Ibrahim Al, Allestam, Görel, Amemura-Maekawa, Junko, Andersson, Sabina, Bangsborg, Jette Marie, Bararossa, Sheila, Beraud, Laetitia, Bernard, Kathryn, Borella, Paola, Brandsema, Petra, Bruin, Jacob P., Buzzigoli, Andrea, Cano, Rosa, Casini, Beatrice, Celenza, Giuseppe, Chalker, Vicki, Collins, Samuel, Rotger, Sebastian Crespi, Cristina, Maria Luisa, Cristino, Sandra, David, Sophia, Jong, Birgitta de, Boer, Jeroen den, Echahidi, Fedoua, Elverdal, Pernille Landsbo, Erdogan, Haluk, Euser, Sjoerd, Franzin, Laura, Fry, Norman K, Gaia, Valeria, Garcia-Nuñez, Marian, Ginevra, Christophe, Pasmal de Ameida Concalves, Elsa Filipa, Gonçalves, Paula, Fernandez, Tiscar Graells, Grottola, Antonella, Gysin, Nicole, Harrison, Timothy G., Höfle, Manfred, Jarraud, Sophie, Jorgensen, Charlotte Svaerke, Joseph, Carol, Slott Kanto, Björn, Kese, Darja, Kindingstad, Louise, Klingenberg, Daniela Emilia, Kösekul, Mehmet, Kozak-Muiznieks, Natalia, Kura, Fumiaki, Kusnetsov, Jaana, Lai, Sandra, Lee, Susanne, Lee, John Vincent, Lindsay, Diane, Lück, Christian, Leuscher, Marcel, der Lugt, Wilco van, Marques, Maria Teresa, Meacci, Marisa, Meghraoui, Alaeddine, Mentasti, Massimo, Mentula, Silja, Mikrut, Antonija, Modol, Josep, Moore, Ginny, Moran-Gilad, Jacob, Morin, Matilda, Otgun, Selin Nar, Nataas, Olav Bjarte, Abadi, Neda Nezam, Pancer, Katarzyna, Pecorari, Monica, Pedro-Botet, Maria Luisa, Pelaz, Carmen, Petzold, Markus, Pissarides, Nicholas, Portal, Edward A. R., Ramliden, Miriam, Raphael, Brian, Reddington, Kate, Ricci, Maria Luisa, Robesyn, Emmanuel, Roisin, Sandrine, Rumpianesi, Fabio, Saenz, Henri, Scaturro, Maria, Schalk, Johanna, Simone, Graf, Bjerregaard, Stine Skotte, Spagnolo, Anna Maria, Spiller, Owen B., Aspelund, Anna Stjarne, Svarrer, Christina Wild, Tartakovshiy, Igor, Templeton, Kate, Uldum, Soren, Veschetti, Enrico, Walker, James, Wallet, France, Wewalka, Guenther, Whapham, Catherine, Wunderlich, Anika and Wybo, Ingrid 2021. Legionella antibiotic susceptibility testing: is it time for international standardization and evidence-based guidance? Journal of Antimicrobial Chemotherapy 76 (5) , pp. 1113-1116. 10.1093/jac/dkab027

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Abstract

Legionella pneumophila, a Gram-negative bacillus, is the causative agent of Legionnaire’s disease, a form of severe community-acquired pneumonia. Infection can have high morbidity, with a high proportion of patients requiring ICU admission, and up to 10% mortality, which is exacerbated by the lack of efficacy of typical empirical antibiotic therapy against Legionella spp. The fastidious nature of the entire Legionellaceae family historically required inclusion of activated charcoal in the solid medium to remove growth inhibitors, which inherently interferes with accurate antimicrobial susceptibility determination, an acknowledged methodological shortfall, now rectified by a new solid medium that gives results comparable to those of microbroth dilution. Here, as an international Legionella community (with authors representing various international reference laboratories, countries and clinical stakeholders for diagnosis and treatment of legionellosis), we set out recommendations for the standardization of antimicrobial susceptibility testing methods, guidelines and reference strains to facilitate an improved era of antibiotic resistance determination.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: Oxford University Press
ISSN: 0305-7453
Funders: Royal Society
Date of First Compliant Deposit: 1 March 2021
Date of Acceptance: 29 January 2021
Last Modified: 30 Jan 2022 11:06
URI: https://orca.cardiff.ac.uk/id/eprint/139112

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