替加环素体外抗菌活性检测方法的分析评价

Analysis and Evaluation of in vitro Antimicrobial Susceptibility Test for Tigecydine

目的通过纸片扩散(KB)法、最小抑菌浓度检测试纸条(MTS)及Vitek 2 Compact系统检测临床常见多重耐药菌对抗菌药物替加环素的体外敏感性,从而评价3种体外药物敏感试验检测的准确性。方法回顾性收集2014年1月-2015年3月分离的140株临床常见的多重耐药菌(不含铜绿假单胞菌),其中非发酵菌鲍曼不动杆菌119株,肠杆菌科21株。采用KB法、Vitek 2法和MTS法检测替加环素的最小抑菌浓度值,并将Vitek 2法和KB法的结果与MTS法进行比较。结果 MTS法、KB法和Vitek 2法检测119株鲍曼不动杆菌对替加环素敏感率分别为90.8%、88.2%、85.7%,差异无统计学意义(P>0.05);检测21株肠杆菌科菌对替加环素敏感率分别为81.0%、76.2%、81.0%,差异无统计学意义(P>0.05)。结论替加环素对铜绿假单胞菌以外的临床常见多重耐药菌具有较好的体外抗菌活性,但是不同的检测方法敏感率有所不同,均存在差异。对于鲍曼不动杆菌,KB法优于Vitek 2法;对于肠杆菌科菌,Vitek 2法检测结果优于KB法。

Objective To detect the in vitro susceptibility of common clinical multidrug-resistant bacteria to tigecycline by disk diffusion（KB）,minimum inhibitory concentrations（MIC） test strip（MTS） and Vitek 2 Compact methods,in order to evaluate the accuracy of the three different susceptibility testing methods.Methods A total of140 multidrug-resistant isolates（excluding Pseudomonas aeruginosa） were collected retrospectively from West China Hospital between January 2014 and March 2015.The inhibitory zone diameters and MIC of tigecycline were determined by KB,Vitek 2 Compact system and MTS respectively.The results of Vitek 2 Compact system and KB method were compared with that of MTS.Results Among the 140 multidrug-resistant isolates,119 were Acinetobacter baumannii,and 21 were Enterobacteriaceae.According to the US Food and Drug Administration standards,the sensitivity rates of 119 Acinetobacter baumannii isolates to tigecycline were 88.2%,85.7%,and 90.8%respectively for KB method,Vitek 2 Compact system and MTS,and those of 21 Enterobacteriaceae were 76.2%,81.0%,and 81.0%,respectively.Conclusions Tigecycline displays effective in vitro antibacterial activity to clinical common multidrug-resistant bacteria（excluding Pseudomonas aeruginosa）,but different susceptibility testing methods have shown different susceptibility rates.For Acinetobacter baumannii,KB method is superior to Vitek 2 Compact system,and for Enterobacteriaceae,Vitek 2 Compact system is superior to KB method.