纸片扩散法在淋球菌药物敏感性检测中准确性的评价  

Evaluation of the accuracy of disk-diffusion testing in Neisseria gonorrhoeae antimicrobial-susceptibility testing

作　　者：周潜 朱小宇 朱邦勇 尹跃平 徐文绮 Zhou Qian;Zhu Xiaoyu;Zhu Bangyong;Yin Yueping;Xu Wenqi(Institute of Dermatology,Chinese Academy of Medical Sciences and Peking Union Medical College,Nanjing 210042,China;National Center for Sexually Transmitted Diseases Control,Chinese Center for Disease Control and Prevention,Nanjing 210042,China;Guangxi Provincial Institute of Dermatology/Dermatology Hospital,Nanning 530007,China)

机构地区：[1]中国医学科学院皮肤病医院(中国医学科学院皮肤病研究所),南京210042 [2]中国疾病预防控制中心性病控制中心,南京210042 [3]广西壮族自治区皮肤病防治研究所/皮肤病医院,南宁530007

出　　处：《国际流行病学传染病学杂志》2023年第4期246-250,共5页International Journal of Epidemiology and Infectious Disease

基　　金：国家科技重大专项(2018ZX10101001-004-003)。

摘　　要：目的评估纸片扩散法在淋球菌药物敏感性检测中的准确性。方法选取2021年在广西14个地市的37家医疗机构收集的584株淋球菌临床分离株,分别使用琼脂稀释法与纸片扩散法进行大观霉素、头孢曲松和头孢克肟的药物敏感性测定,计算纸片扩散法与琼脂稀释法的一致性。结果大观霉素、头孢曲松和头孢克肟纸片扩散法的分类一致率分别为87.64%、83.45%和80.31%,配对χ^(2)检验结果表明两种方法检测的药物敏感性结果存在显著性统计学差异(χ^(2)=65.000、52.128和95.870,P均<0.001)。结论某些厂家的纸片扩散法可能不是临床实践中筛选淋球菌耐药菌株的合适选择,未来需要更多高准确性的纸片以实现纸片扩散法在淋球菌耐药筛查中的应用,或在使用前对不同厂家生产的纸片扩散法进行评估,选择与琼脂稀释法一致性较好的进行测试。ObjectiveTo evaluate the accuracy of disk-diffusion testing in Neisseria gonorrhoeae antimicrobial-susceptibility testing.MethodsIn 2021,584 strains of Neisseria gonorrhoeae were collected from 37 medical institutions in 14 cities in Guangxi area,and the drug susceptibility of spectinomycin,ceftriaxone and cefixime was determined using agar dilution method and disk-diffusion testing.The consistency between disk-diffusion testing and agar dilution method was calculated.ResultsThe concordance rates of classification by disk-diffusion testing were 87.64%,83.45%and 80.31%for spectinomycin,ceftriaxone and cefixime,respectively.The results of paired chi-square test showed that the drug susceptibility results detected by two methods were significantly different(χ^(2)=65.000,52.128 and 95.870,P<0.001).ConclusionsSome manufacturers'disk may not be an appropriate choice for screening resistant gonorrhea strains by the disk-diffusion testing in clinical practice.More test disks with improved accuracy are needed in the future to enable the application of the disk diffusion testing in Neisseria gonorrhoeae antimicrobial-susceptibility testing.In addition,it needs to evaluate the accuracy of different disks before clinical application and select those with better agreement with agar dilution methods.

关 键 词：淋病奈瑟球菌 纸片扩散法 琼脂稀释法 准确性评价 

分 类 号：R759.2[医药卫生—皮肤病学与性病学]