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首页> 外文期刊>Journal of Medical Microbiology: An Official Journal of the Pathological Society of Great Britain and Ireland >Comparison of susceptibility testing methods for determining the activity of colistin against Gram-negative bacilli of clinical origin
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Comparison of susceptibility testing methods for determining the activity of colistin against Gram-negative bacilli of clinical origin

机译：确定大肠菌素对临床来源的革兰氏阴性杆菌活性的药敏试验方法的比较

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Purpose. Despite being in clinical use for decades, colistin susceptibility testing remains challenging because of its inherent cationic properties. We aimed to compare the performance characteristics of different methods for testing susceptibility to colistin in a series of clinical isolates of Gram-negative bacilli.Methodology. One hundred and nine clinical isolates of Klebsiella pneumoniae (n=34), Escherichia coli (n=20), Acinetobacter baumannii (n=17) and Pseudomonas aeruginosa (n=38) were studied for colistin susceptibility using broth microdilution (BMID), broth macrodilution (BMAD), agar dilution (AD) as well as disc-diffusion (DD) utilizing two different commercial disc sources.Results. By using BMID as reference method, 88 and 21 isolates were found to be colistin susceptible and resistant, respectively. Overall, acceptable essential agreement (EA) and categorical agreement (CA) were observed between BMAD and reference method (100?%). Whereas the AD method revealed the lowest rate of EA (61.7, 11.7, 5.0 and 5.2?% for K. pneumoniae, A. baumannii, E. coli and P. aeruginosa, respectively), it showed acceptable or near acceptable CA for K. pneumoniae (100?%), E. coli (100?%) and A. baumannii (88.2?%) isolates but not for P. aeruginosa (13.1?%). DD failed to detect resistance in colistin-resistant (colR) P. aeruginosa (n=5, very major errors of 100?%) but successfully identified all high-level colistin-resistant A. baumannii and K. pneumoniae isolates.Conclusion. We found BMAD to be very reliable for colistin MIC determination. Methods AD and DD should not be used for colistin susceptibility testing in P. aeruginosa isolates as these are associated with false-resistant and -susceptible results, respectively.
机译：目的。尽管在临床上已经使用了数十年，但是粘菌素敏感性测试由于其固有的阳离子性质而仍然具有挑战性。我们旨在比较在一系列革兰氏阴性杆菌临床分离株中检测大肠菌素敏感性的不同方法的性能特征。使用肉汤微稀释液（BMID）研究了119例肺炎克雷伯菌（n = 34），大肠杆菌（n = 20），鲍曼不动杆菌（n = 17）和铜绿假单胞菌（n = 38）的临床分离株对大肠菌素的敏感性，肉汤大稀释（BMAD），琼脂稀释（AD）以及圆盘扩散（DD）利用两种不同的商业圆盘来源。通过使用BMID作为参考方法，发现88和21株分离株分别对大肠菌素敏感和耐药。总体而言，在BMAD和参考方法之间观察到可接受的必要协议（EA）和类别协议（CA）（100％）。 AD方法显示最低的EA率（肺炎克雷伯菌，鲍曼不动杆菌，大肠杆菌和铜绿假单胞菌分别为61.7％，11.7％，5.0％和5.2％），但它显示出对K可接受或接近可接受的CA。肺炎杆菌（100％），大肠杆菌（100％）和鲍曼不动杆菌（88.2％）分离株，但铜绿假单胞菌（13.1％）没有。 DD无法检测到对大肠菌素耐药（colR）的铜绿假单胞菌（n = 5，非常大的误差为100％），但成功地鉴定了所有对大肠菌素耐药的鲍曼不动杆菌和肺炎克雷伯菌。我们发现BMAD成为粘菌素MIC测定非常可靠的。方法AD和DD不应用于铜绿假单胞菌分离株的大肠菌素敏感性测试，因为它们分别与假药耐药性和敏感性结果相关。

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