鲍曼不动杆菌对8种常用抗菌药物敏感试验不同方法的比较  

Susceptibility of Acinetobacter baumannii isolates to eight antimicrobial agents tested by different methods

作　　者：温海楠[1] 谢守军[1] 赵建宏[2,3] 孙倩 魏宏莲[2] 时东彦[2] 李志荣[3] 徐丽 闻海峰 

机构地区：[1]承德医学院附属医院检验科,河北承德067000 [2]河北医科大学第二医院检验科 [3]河北省临床检验中心 [4]沧州市人民医院检验科 [5]河北医科大学第三医院检验科

出　　处：《中国感染与化疗杂志》2017年第6期680-684,共5页Chinese Journal of Infection and Chemotherapy

基　　金：河北省科技厅基础条件平台建设项目(河北省医学微生物菌种资源标准平台建设10966142D)

摘　　要：目的分析河北省细菌耐药性监测网(Hebarin)鲍曼不动杆菌耐药性监测数据,验证不同药敏试验方法结果,提高耐药性监测数据质量,指导临床实验室使用合理的药敏试验方法。方法回顾性分析Hebarin鲍曼不动杆菌药敏数据。收集126株鲍曼不动杆菌,应用E试验法、纸片扩散法和VITEK仪器法检测其对哌拉西林-他唑巴坦、阿米卡星、庆大霉素、环丙沙星、左氧氟沙星、头孢他啶、亚胺培南和美罗培南的药敏试验结果。结果 126株鲍曼不动杆菌药敏试验结果显示,3种方法中细菌对哌拉西林-他唑巴坦、阿米卡星、庆大霉素、左氧氟沙星、头孢他啶药敏结果存在明显差异(P<0.05);纸片扩散法的分类一致性、一般错误率、严重错误率、极严重错误率均在可接受范围,纸片扩散法和VITEK仪器法对哌拉西林-他唑巴坦、阿米卡星、左氧氟沙星的分类一致性存在明显差异(P<0.05)。结论不同的药敏试验方法会导致不同的耐药结果,从而使耐药监测数据出现方法学的差异。应用VITEK仪器进行药敏试验时,哌拉西林-他唑巴坦、阿米卡星、左氧氟沙星的药敏结果要结合纸片扩散法或E试验方法进行验证,以便更加准确地指导临床用药。Objective The purpose of this study was to analyze the susceptibility profile of Acinetobacter baumannii to antimicrobial agents, and validate the results of different antimicrobial susceptibility testing methods, for improving the quality of antibiotic resistance monitoring data. Methods The susceptibility data of Hebei Provincial Antimicrobial Resistant Investigation Net were analyzed retrospectively and 126 strains of A. baumannii were collected. The susceptibility of A. baumannii to piperacillintazobactam, amikacin, gentamicin, ciprofloxacin, levofloxacin, ceftazidime, imipenem, and meropenem was tested by E-test, KirbyBauer method and VITEK system. Results The susceptibility results of the 126 A. baumannii strains showed that the susceptibility to piperacillin-tazobactam, amikacin, gentamicin, levofloxacin and ceftazidime was significantly different between the three methods(P<0.05). The categorical agreement, major error, minor error, and very major error of Kirby-Bauer method were within acceptable range. There were evident difference in classification consistency for piperacillin-tazobactam, amikacin, levofloxacin between Kirby-Bauer method and VITEK(P <0.05). Conclusions Different antimicrobial susceptibility testing methods may lead to different results of resistance monitoring data. Bias may be generated in antibiotic resistance surveillance if different methods are used. The susceptibility results of piperacillin-tazobactam, amikacin, levofloxacin derived from VITEK system should be validated by Kirby-Bauer or E-test method.

关 键 词：鲍曼不动杆菌 E试验法 纸片扩散法 VITEK 

分 类 号：R446.5[医药卫生—诊断学]