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

2021; Oxford University Press; Volume: 76; Issue: 5 Linguagem: Inglês

10.1093/jac/dkab027

1460-2091

Edward Portal, Ghislaine Descours, Christophe Ginévra, M. Mentasti, Baharak Afshar, Meera Chand, Jessica Day, Fedoua Echahidi, L. Franzin, Valeria Gaia, Christian Lück, Alaeddine Meghraoui, Jacob Moran‐Gilad, Maria Luisa Ricci, Gérard Lina, Søren Anker Uldum, Jonas M. Winchell, Robin Howe, Kathryn Bernard, O. Brad Spiller, Victoria J. Chalker, Sophie Jarraud, Catherine Ahlen, Ibrahim Al Hashmi, G. Allestam, Junko Amemura‐Maekawa, Sabina Andersson, Jette Bangsborg, Sheila Bararossa, Laetitia Béraud, Kathryn Bernard, Paola Borella, Petra Brandsema, Jacob P. Bruin, Andrea Buzzigoli, R. Cano, Beatrice Casini, Giuseppe Celenza, Vicki Chalker, Samuel Collins, Sebastian Crespi Rotger, Maria Luisa Cristina, Sandra Cristino, Sophia David, B de Jong, Jeroen den Boer, Fedoua Echahidi, Pernille L. Elverdal, Haluk Erdoğan, Sjoerd M. Euser, L. Franzin, Norman K. Fry, Valeria Gaia, Marian García-Núñez, Christophe Ginévra, Elsa Filipa Pasmal de Ameida Concalves, Paula Gonçalves, Tiscar Graells Fernandez, Antonella Grottola, Nicole Gysin, Timothy G. Harrison, Manfred G. Höfle, Sophie Jarraud, Charlotte Sværke Jørgensen, Carol Joseph, Björn Slott Kanto, Darja Keše, Louise Kindingstad, Daniela Emilia Klingenberg, Mehmet Kösekul, Natalia A. Kozak‐Muiznieks, Fumiaki Kura, Jaana Kusnetsov, Sandra Lai, Susanne Lee, John Vincent Lee, Diane Lindsay, Christian Lück, Marcel Leuscher, Wilco van der Lugt, Maria Teresa da Silva Pinto Marques, Marisa Meacci, Alaeddine Meghraoui, M. Mentasti, Silja Mentula, Antonija Mikrut, Josep María Mòdol, Ginny Moore, Jacob Moran‐Gilad, Matilda Morin, Selin Nar Ötgün, Olav Bjarte Nataas, Neda Nezam Abadi, Katarzyna Pancer, Monica Pecorari, María Luisa Pedro-Botet, C. Pelaz, Markus Petzold, Nicholas Pissarides, Edward Portal, Miriam S. Ramliden, Brian H. Raphael, Kate Reddington, Maria Luisa Ricci, Emmanuel Robesyn, Sandrine Roisin, Fabio Rumpianesi, Henri Saenz, Maria Scaturro, Johanna A.C. Schalk, Graf Simone, Stine Skotte Bjerregaard, Anna Maria Spagnolo, O. Brad Spiller, Anna Stjarne Aspelund, Christina Wild Svarrer, Igor Tartakovshiy, Kate Templeton, Søren Anker Uldum, E. Veschetti, James T. Walker, France Wallet, Guenther Wewalka, Catherine Whapham, Anika Wunderlich, Ingrid Wybo,

Antibiotic Resistance in Bacteria

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.