VITEK-2 Compact检测奇异变形杆菌、摩根摩根菌、铜绿假单胞菌的部分药敏结果准确性评价

Accuracy Evaluation of Partial Drug Sensitivity Results of Vitek-2 Compact Detection for Proteus Singularis,Morgan Morgan and Pseudomonas Aeruginosa

目的探讨VITEK-2 Compact检测奇异变形杆菌、摩根摩根菌和铜绿假单胞菌的部分药敏结果的准确性。方法收集2017年3月~2020年3月临床分离的58株奇异变形杆菌、32株摩根摩根菌和280株铜绿假单胞菌,以纸片扩散法(K-B法)为参考方法,用VITEK 2 Compact AST-GN16药敏卡检测前两种菌对亚胺培南(IPN)的敏感度,用AST-GN09药敏卡检测铜绿假单胞菌对亚胺培南、美罗培南(MEM)和氨曲南(ATM)的敏感度。结果仪器法与K-B法比较,经58株奇异变形杆菌药敏结果显示,其标准符合率(CA)、一般错误率(MIE)、严重错误率(ME)和极严重错误率(VME)分别为3.45%,6.90%,0%和89.66%,两种方法之间的差异有统计学意义(χ2=186.66,P<0.05);32株摩根摩根菌药敏结果显示,其CA,MIE,ME和VME分别为12.5%,6.25%,81.25%和0%,即两种方法之间的差异有统计学意义(χ2=155.56,P<0.05);280株铜绿假单胞菌药敏结果显示,其CA,MIE,ME和VME分别为88.93%,10.71%,0.36%和0%,即IPN两种方法之间的差异有统计学意义(χ2=9.84,P<0.05)。MEM和ATM的两种方法比较,其CA,MIE,ME和VME分别为95.00%,5.00%,0和0;68.57%,27.86%,1.07%和2.5%,即两种方法药敏结果的差异无统计学意义(χ2=4.58,0.78,P>0.05)。两种方法检测的分类一致性中,只有MEM结果差异无统计学意义(χ2=5.12,P>0.05),其它均有统计学意义(χ2=11.72~186.68,均P<0.05)。结论用VITEK-2 Compact AST-GN09检测铜绿假单胞菌对MEM敏感度结果可靠,无需验证,而对IPN和ATM的敏感度结果不可靠,需验证;VITEK-2 Compact AST-GN16检测奇异变形杆菌和摩根摩根菌的IPN敏感度结果也存在不同程度的差异,在工作中需采用K-B法进行补充修正,以便更加准确的指导临床用药。

Objective To investigate the accuracy of VITEK-2 Compact in the detection of partial drug sensitivity of Proteus singularis,P.Morgan morgan and Pseudomonas aeruginosa.Methods 58 strains of Proteus singularis,32 strains of P.Morgan morgan and 280 strains of Pseudomonas aeruginosa were collected from March 2017 to March 2020.The paper diffusion method(K-B method)was used as the reference method,the sensitivity of the first two strains to IPN was detected by VITEK 2 Compact AST-GN16 drug sensitive card,the sensitivity of Pseudomonas aeruginosa to IPN,MEM and ATM was detected by AST-GN09 drug sensitive card.Results The instrument method was compared with K-B method,the results of drug sensitivity of 58 strains of Proteus strangis showed thatthe standard coincidence rate(CA),the general error rate(MIE),the serious error rate(ME)and the very serious error rate(VME)were 3.45%,26.89%,0%and 89.66%,respectively,and there were significant differences between the two methods(χ2=186.66,P<0.05).The drug sensitivity of 32 strains of P.Morgan morgan showed that CA,MIE,ME and VME were 12.5%,6.25%,81.25%and 0,respectively,and the difference between the two methods was statistically significant(χ2=155.56,P<0.05).The drug sensitivity of 280 Pseudomonas aeruginosa strains showed that CA,MIE,ME and VME were 88.93%,10.71%,0.36%and 0 respectively,and the difference between IPN was statistically significant(χ2=9.84,P<0.05).Comparison of ATM and MEN,the values of CA,MIE,ME and VME were 95.00%,5.00%,0 and 0 respectively,and 68.57%,27.86%,1.07%,2.50%,and there was no difference in drug sensitivity between ATM and MEM methods(χ2=0.78 and 4.58,P>0.05).The two methods were detected in the classification consistency,Only MEM results were not statistically significant(χ2=5.12,P>0.05),and the others were statistically significant(χ2=11.72~186.68,all P<0.05).Conclusion The results of the sensitivity of Pseudomonas aeruginosa to MEM detected by Vitek-2 Compact AST-GN09 are reliable without verification and the sensitivity results to IPN and ATM are not reliable and need to be verified.The IPN sensitivity results of VITEK-2 Compact AST-GN16 in detection of Proteus singularis and P.Morgan morgan also variedto different degrees,so K-B method should be used for supplement and modification in the workto guide clinical medication more accurately.