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首页> 外文期刊>Journal of Clinical Microbiology >Precision of Vancomycin and Daptomycin MICs for Methicillin-Resistant Staphylococcus aureus and Effect of Subculture and Storage
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Precision of Vancomycin and Daptomycin MICs for Methicillin-Resistant Staphylococcus aureus and Effect of Subculture and Storage

机译：万古霉素和达托霉素MICs对耐甲氧西林金黄色葡萄球菌的精密度及继代培养和贮藏的影响

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The reproducibility of vancomycin and daptomycin MICs, measured by broth microdilution (BMD) and Etest, was prospectively assessed for 10 methicillin-resistant Staphylococcus aureus (MRSA) isolates from the blood samples from patients on vancomycin therapy. The isolates were tested at the time of isolation from blood and following 5, 10, and 20 subcultures and at 1, 3, 6, and 12 months of storage at ?70°C. The MICs were determined by Etest and BMD using two different manufacturers (BBL and Difco) of cation-adjusted Mueller-Hinton broth (CA-MHB), and using three different drug powders: vancomycin from Sigma, vancomycin from Novation, and daptomycin from Cubist. The antimicrobial concentrations tested were 0.25, 0.5, 0.75, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, and 4.0 μg/ml. Two isolates were vancomycin intermediate and daptomycin nonsusceptible, and two isolates had reduced susceptibility to vancomycin (BMD MIC, 1.5 or 2.0 μg/ml). The vancomycin MICs were significantly higher in the BBL CA-MHB than those in the Difco CA-MHB, and with Sigma versus Novation vancomycin powder. The daptomycin MICs were also significantly higher in the BBL CA-MHB. The Etest MICs were significantly higher than those obtained by BMD for vancomycin but not for daptomycin. The average precision of the vancomycin BMD MICs when analyzing 20 results was ±1.10-fold log2 dilutions, and it was ±1.67-fold for daptomycin (10 results). The average precision for Etest was ±1.11-fold for vancomycin and ±1.16-fold for daptomycin. No significant change in MICs was noted following 5, 10, or 20 subcultures or at up to 6 months of frozen storage. However, the vancomycin MICs alone were significantly lower (0.74-fold) following 12 months of frozen storage. From these data, despite variations in CA-MHB and antimicrobial powder, the MIC result precision was <0.5 log2 dilutions in a single laboratory, suggesting that testing interdilution MICs (e.g., MICs between serial 2-fold dilutions) is a possibility. A more accurate method for measuring vancomycin MIC results is thus possible, but further standardization of BMD testing would be required to achieve this goal.
机译：前瞻性评估了通过肉汤微量稀释（BMD）和Etest测定的万古霉素和达托霉素MIC的可重复性，从万古霉素治疗患者的血样中分离出10株耐甲氧西林金黄色葡萄球菌（MRSA）。在从血液中分离后以及在5、10和20次传代培养后以及在70°C下保存1、3、6和12个月时测试分离株。 MIC是通过Etest和BMD使用两种不同的阳离子调节Mueller-Hinton肉汤（CA-MHB）制造商（BBL和Difco），并使用三种不同的药物粉末来测定的：Sigma公司的万古霉素，Novation公司的万古霉素和Cubist公司的达托霉素。所测试的抗菌剂浓度为0.25、0.5、0.75、1.0、1.5、2.0、2.5、3.0、3.5和4.0μg/ ml。两个分离株是万古霉素中间体和达托霉素不敏感，两个分离株对万古霉素的敏感性降低（BMD MIC，1.5或2.0μg/ ml）。 BBL CA-MHB中的万古霉素MIC明显高于Difco CA-MHB中的万古霉素MIC，与Sigma相比，Novation万古霉素粉末的万古霉素MIC更高。 BBL CA-MHB中达托霉素的MICs也显着较高。 Etest MIC显着高于BMD获得的万古霉素，而不是达托霉素。分析20个结果时，万古霉素BMD MIC的平均精确度为±1.10倍log 2 稀释度，对于达托霉素，其平均精确度为±1.67倍（10个结果）。万古霉素Etest的平均精密度为±1.11倍，达托霉素为±1.16倍。在5次，10次或20次继代培养或冷冻保存长达6个月后，MIC没有显着变化。但是，冷冻保存12个月后，仅万古霉素的MIC显着降低（0.74倍）。根据这些数据，尽管CA-MHB和抗菌药粉存在差异，但在单个实验室中MIC结果的精确度为<0.5 log 2 稀释，这表明测试稀释度MIC（例如，连续2倍之间的MIC）稀释）。因此，可以使用一种更准确的方法来测量万古霉素的MIC结果，但要实现这一目标，还需要BMD测试的进一步标准化。

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