K-B法和E-test法测定150株CRE对头孢他啶/阿维巴坦药敏的一致性分析  

To analyze the consistency of drug susceptibility of 150 strains of carbapenem-resistant Enterobacteriaceae to ceftazidime/avibactam by K-B method and E-test method

作　　者：陈福红 张思琴 齐艳[2] CHEN Fu-hong;ZHANG Si-qin;QI Yan(Clinical Laboratory,Dingqiao Hospital,Hangzhou Hospital of Traditional Chinese Medicine Dingqiao Ward,Hangzhou,Zhejiang 310021,China;不详)

机构地区：[1]杭州市丁桥医院杭州市中医院丁桥院区检验科,浙江310021 [2]杭州市中医院检验科

出　　处：《中国卫生检验杂志》2022年第22期2724-2727,共4页Chinese Journal of Health Laboratory Technology

基　　金：浙江省医药卫生科技计划项目(2020KY229)。

摘　　要：目的 利用纸片扩散法(K-B法)和E-test法测定碳青霉烯耐药肠杆菌科细菌(CRE)对头孢他啶/阿维巴坦(CZA)的体外药物敏感性,分析二者结果的一致性。方法 从临床标本中分离出150株CRE,其中肺炎克雷伯菌127株,大肠埃希菌10株,黏质沙雷菌5株,阴沟肠杆菌4株,产酸克雷伯菌2株,克氏柠檬酸杆菌1株,弗劳地柠檬酸杆菌1株;使用K-B法和E-test法2种方法检测所分离CRE菌株对头孢他啶/阿维巴坦的体外药物敏感性。结果 本实验的CRE菌株中比例最高的是肺炎克雷伯菌(84.67%), 2种方法结果不一致的11株菌株均为肺炎克雷伯菌,非肺炎克雷伯菌的CRE菌株2种方法结果一致。头孢他啶/阿维巴坦纸片扩散法测定为20 mm时,11株菌株K-B法判定为耐药,E-test法结果敏感,二者结果不一致,K-B法测定为其他数值时,2种方法结果一致;K-B法耐药菌株共25株,耐药率为16.67%,E-test法耐药菌株共14株,耐药率为9.33%。结论 当碳青霉烯耐药的肺炎克雷伯菌头孢他啶/阿维巴坦K-B法测量结果为20 mm时,K-B法和E-test法存在差异,K-B法需用E-test或微量肉汤稀释法进行复查后报告。Objective This study aims to detect the in-vitro susceptibility of ceftazidime-avibactam to carbapenem-resistant Enterobacteriaceae(CRE)by disk diffusion(K-B)method and E-test method and to analyze the result consistency between the two methods.Methods The 150 CRE strains were isolated from clinical specimens,including 127 Klebsiella pneumoniae strains,10 Escherichia coli strains,5 Serratia marcescens strains,4 Enterobacter clovis strains,2 Klebsiella acidophilus strains,1 Citrobacter krei strain and 1 Citrobacter freudi strain.The in-vitro susceptibility of ceftazidime/avibactam was detected by K-B method and E-test method.Results Klebsiella pneumoniae(84.67%)occupies the highest proportion of CRE strains.The 11 strains with inconsistent results by the two methods were all Klebsiella pneumoniae,and consistency of the results was observed in the CRE strains without Klebsiella pneumoniae.When the judging standard was set as 20 mm by the ceftazidime/avibactam disk diffusion method,11 strains were judged to be resistant by K-B method,and the results of E-test method were sensitive,but the results of the two methods were inconsistent.When other values were observed by K-B method,the results of the two methods were consistent.A total of 25 resistant strains were observed by K-B method,with a drug resistance rate of 16.67%,and 14 resistant strains were observed by E-test method,with a drug resistance rate of 9.33%.Conclusion When the resistance of carbapenem-resistant Klebsiella pneumoniae to ceftazidime/avibattam by K-B method was 20 mm,there was a certain difference on the resistance results between K-B method and E-test method,and the result should be reviewed by E-test or microbroth dilution method.

关 键 词：头孢他啶/阿维巴坦 碳青霉烯耐药肠杆菌科细菌 浓度梯度法 纸片扩散法 

分 类 号：R446.5[医药卫生—诊断学]