不同方法检测黏液型铜绿假单胞菌药物敏感性结果准确性探讨

Accuracy evaluation of different antibiotic susceptibility testing for mucoid isolates of Pseudomonas aeruginosa

目的探讨黏液型铜绿假单胞菌(PA)药物敏感性检测方法准确性,以找出适合临床开展的、准确的药物敏感性检测方法。方法分别用药物敏感性纸片琼脂扩散法(K-B法)、假单胞菌和非发酵菌药物敏感性试剂盒(ATB PSE5)、仪器法(MicroScan WalkAway 96 plus和VITEK 2)和微量肉汤稀释法同时检测66株黏液型PA,以微量肉汤稀释法作为参考方法,其余方法作为测试方法进行对照分析。结果 K-B法与微量肉汤稀释法的完全符合率(CA)为92.63%,严重错误(VME)为0.30%,重大错误(ME)为3.13%,一般错误(MIE)为3.94%;ATB PSE5与与微量肉汤稀释法的CA为88.89%,VME为0.83%,ME为5.83%,MIE为4.44%;MicroScan仪器法与微量肉汤稀释法的CA为89.38%,VME为0.34%,ME为5.19%,MIE为5.07%。VITEK 2因结果缺失严重未进行比较。结论临床常用检测PA药物敏感性的方法中,以K-B法检测黏液型PA最为可靠,但应延长孵育时间至48 h或放至CO2孵箱24 h后读取结果更为直观、准确。

Objective To investigate the accuracy of different methods of antibiotic susceptibility testing for mucoid isolates of Pseudomonas aeruginosa （PA）. Methods A total of 66 isolates of mucoid PA were detected by Kirby-Bauer （K-B） method, ATB PSE5 kits, MicroScan WalkAway 96 plus, VITEK 2 and micro-broth dilution method. The micro- broth dilution method was adopted as reference method, and the other methods were as test methods. Results Compared to micro-broth dilution method, the complete accordances （CA） of K-B method, ATB PSE5 kits and MicroScan were 92. 63%, 88.89% and 89.38%. The very major errors （VME） of the 3 methods were 0.30%, 0.83% and 0.34% , respectively. The major errors （ME） of the 3 methods were 3.13% ,5.83% and 5.19%. The minor errors （MIE） of the 3 methods were 3.94% , 4.44% and 5.07%. The results lack in VITEK 2, since the relevant data were not analyzed. Conclusions K-B method is a reliable method for mucoid PA antibiotic susceptibility testing_ esneciallv nrolonging the incuhation time to 48 h or incubating in C02 incubator for 24 h.