VITEK-2 Compact仪器法检测葡萄球菌属克林霉素诱导性耐药的评价

Effectiveness of VITEK-2 Compact in detection of staphylococcus-induced resistance to clindamycin

目的评价VITEK-2Compact仪器法检测葡萄球菌属克林霉素诱导性耐药的应用价值。方法分别采用VITEK-2Compact仪器法和D试验检测83株金黄色葡萄球菌,52株凝固酶阴性葡萄球菌属的诱导性克林霉素耐药,两种方法的比较采用卡方检验,同时以"D试验"为金标准,计算VITEK-2Compact仪器法的特异性、敏感性、假阳性率、假阴性率。结果经卡方检验,两种方法在检测金黄色葡萄球菌克林霉素诱导性耐药方面具有很好的一致性,特异性为100.0%,敏感性为95.8%,kappa值为0.97,假阴性率为4.2%;两种方法在检测凝固酶阴性葡萄球菌方面结果一致性较好,特异性、敏感性分别为83.3%、100.0%,kappa值为0.435,假阳性率为16.7%。结论 VITEK-2Compact仪器法在检测金黄色葡萄球菌诱导性克林霉素耐药方面与D试验有很好的一致性,但存在假阴性可能;在检测凝固酶阴性葡萄球菌属细菌方面,与D试验有较好的一致性,存在一定的假阳性。

OBJECTIVE To evaluate the possibility of clinical application VITEK-2 Compact in the detection of inducible clindamycin resistance in Staphylococci.METHODS A total of 83 S.saureus isolates and 52 coagulase-negative Staphylococcus（CNS） isolates were detected by VITEK-2 Compact and D-zone test.The results were analyzed statistically by χ2 test.The specificity,sensitivity,false positive rate and false negative rate were used to compare the difference between two detection methods.RESULTS The detection results of inducible clindamycin resistance in S.saureus by VITEK-2 Compact and D-zone test did not show significant difference.The sensitivity and specificity of VITEK-2 Compact method were 95.8% and 100.0%（kappa=0.97）.The false negative rate was 4.2%.The detection results of inducible clindamycin resistance in coagulase-negative Staphylococcus by VITEK-2 Compact and D-zone test were significantly different.The sensitivity and specificity of VITEK-2 Compact method were respectively 100.0 %,83.3%（kappa=0.435）.The false positive rate was 16.7%.CONCLUSION The detection results of inducible clindamycin resistance in S.saureus by VITEK-2 Compact show an excellent concordance with D-zone test.