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首页> 外文期刊>Journal of Clinical Microbiology >Detection of Methicillin-Resistant Coagulase-Negative Staphylococci by the Vitek 2 System
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Detection of Methicillin-Resistant Coagulase-Negative Staphylococci by the Vitek 2 System

机译：通过Vitek 2系统检测耐甲氧西林的凝固酶-阴性葡萄球菌

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The accurate performance of the Vitek 2 GP67 card for detecting methicillin-resistant coagulase-negative staphylococci (CoNS) is not known. We prospectively determined the ability of the Vitek 2 GP67 card to accurately detect methicillin-resistant CoNS, with mecA PCR results used as the gold standard for a 4-month period in 2012. Included in the study were 240 consecutively collected nonduplicate CoNS isolates. Cefoxitin susceptibility by disk diffusion testing was determined for all isolates. We found that the three tested systems, Vitek 2 oxacillin and cefoxitin testing and cefoxitin disk susceptibility testing, lacked specificity and, in some cases, sensitivity for detecting methicillin resistance. The Vitek 2 oxacillin and cefoxitin tests had very major error rates of 4% and 8%, respectively, and major error rates of 38% and 26%, respectively. Disk cefoxitin testing gave the best performance, with very major and major error rates of 2% and 24%, respectively. The test performances were species dependent, with the greatest errors found for Staphylococcus saprophyticus. While the 2014 CLSI guidelines recommend reporting isolates that test resistant by the oxacillin MIC or cefoxitin disk test as oxacillin resistant, following such guidelines produces erroneous results, depending on the test method and bacterial species tested. Vitek 2 cefoxitin testing is not an adequate substitute for cefoxitin disk testing. For critical-source isolates, mecA PCR, rather than Vitek 2 or cefoxitin disk testing, is required for optimal antimicrobial therapy.
机译：Vitek 2 GP67卡在检测耐甲氧西林的凝固酶阴性葡萄球菌（CoNS）方面的准确性能尚不清楚。我们前瞻性地确定了Vitek 2 GP67卡能够准确检测耐甲氧西林的CoNS的能力，并在2012年的4个月内将 mecA PCR结果用作金标准。该研究包括240个连续收集的非重复CoNS分离株。通过圆盘扩散测试确定了所有分离株的头孢西丁敏感性。我们发现，这三个测试系统Vitek 2 oxacillin和cefoxitin测试以及cefoxitin纸片药敏测试缺乏特异性，在某些情况下还缺乏检测耐甲氧西林的敏感性。 Vitek 2奥沙西林和头孢西丁测试的主要错误率分别为4％和8％，主要错误率分别为38％和26％。磁盘头孢西丁测试显示出最佳的性能，主要错误率和主要错误率分别为2％和24％。测试性能取决于物种，发现腐生葡萄球菌的误差最大。尽管2014年CLSI指南建议报告经oxacillin MIC或头孢西丁圆盘测试具有耐药性的分离株为oxacillin耐药性，但遵循此类指南会产生错误结果，具体取决于测试方法和所测试的细菌种类。 Vitek 2头孢西丁测试不能替代头孢西丁磁盘测试。对于关键来源的分离物，需要采用 mecA PCR而不是Vitek 2或头孢西丁磁盘测试，才能获得最佳的抗菌治疗。

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