对头孢唑啉敏感及耐药菌的K-B法验证结果分析  

Verification results of K-B method on cefazolin sensitivity and drug-resistance bacteria

作　　者：刘霞[1] 邹自英[1] 刘媛[1] Liu Xia;Zou Ziying;Liu Yuan(Department of Labomtory,General Hospital of Chengdu Military Command,Chengdu,Sichuan,610083,China)

机构地区：[1]成都军区总医院检验科,成都610083

出　　处：《西南国防医药》2018年第4期343-345,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的采用体外K-B法对梅里埃VITEK2 compact全自动微生物分析仪检测肠杆菌科细菌的头孢唑啉敏感性结果进行验证,以期为临床准确用药提供依据。方法对已用梅里埃VITEK2 compact全自动微生物分析仪检测过的320株非尿液标本中的肠杆菌科敏感菌和164株尿液标本的肠杆菌科耐药菌,使用手工K-B法进行验证,依据2017 CLSI-S27标准判定药敏结果。结果 320株非尿液标本中头孢唑啉药敏结果为敏感菌株主要分离自呼吸道、全血和脓液等标本,其中92.50%为敏感,7.50%为中介,无耐药菌株;选择的164株尿液分离仪器检测最小抑菌浓度(MIC)≥8μg/ml的耐药菌株,K-B法检测结果全部MIC≤14 mm,判定为耐药。结论现在医院普遍使用的梅里埃公司的系列全自动微生物分析仪,它对头孢唑啉的测试下限是4μg/ml,按照CLSI标准不能明确是中介还是敏感,由于仪器无法区分标本是否尿液来源,≥8μg/ml仪器判断为耐药的菌株,其中8μg/ml和16μg/ml的菌株可能实际为敏感菌株,为确保药敏报告结果的准确性,需进行K-B法验证,以指导临床正确使用头孢唑啉。Objective To verify the effects of VITEK2 compact automatic microorganisms analyzer in detecting cefazolin sensitivity of entei’obacteriaceae"with the external K-B method so as to lay a solid basis for clinical medication.Methods A total of 320 strains of enterobacteriaceae sensitive bacteria in non-urine specimen and 164 strains of enterobacteriaceae drug-resistance bacteria in urine specimen subject to the detection by use of a VITEK2 compact automatic microorganisms analyzer were verified with the manual K-B method.Drug sensitivity was determined according to the standard 2017 CLSI-S27.Results For the 320 strains of enterobacteriaceae sensitive bacteria in non-urine specimen,the drug sensitivity result was that sensitive bacterial strains were mainly separated from the respiratory tract,whole blood and fester,among which,92.50%represented sensitivity and 7.50%represented medium and there was no drug-resistance bacterial strain;among the 164 strains of enterobacteriaceae sensitive bacteria in urine specimen,the analyzer detected drug-resistance bacterial strains with a minimal inhibitory concentration(MIC)≥8μg/ml.According to the K-B method,all strains showed MIC≤14 mm,thus determined as drug-resistant.Condusion At present,Biomerieux's VITEK2 compact automatic microorganisms analyzer is widely used in hospitals.Its lower limit for cefazolin detection is 4μg/ml,and this cannot be clearly categorized as medium or sensitivity according to the CLSI standard.As the instrument cannot determine whether a specimen is urine-sourced,bacterial strains showing a detection concentration≥8μg/ml are determined as drug-resistant,in which 8μg/ml and 16μg/ml bacterial strains may be actually the sensitive strains.To ensure accuracy of drug sensitivity test result,it is necessary to adopt the K-B method for verification so as to instruct the correct application of cefazolin in clinical practices.

关 键 词：头孢唑啉 敏感性 仪器鉴定 K-B法 

分 类 号：R446[医药卫生—诊断学]