纸片扩散法检测淋病奈瑟菌的药物敏感性

Evaluation of Kirby-Bauer disc diffusion test for antibiotic susceptibility of Neisseria gonorrhoeae

目的探讨纸片扩散法检测淋病奈瑟菌对7种监测药物敏感性的准确性。方法以琼脂稀释法作为参考方法,采用纸片扩散法(K-B法)配对检测60株临床淋病奈瑟菌对头孢曲松、头孢克肟、大观霉素、阿奇霉素、环丙沙星、四环素和青霉素的敏感性,比较两种方法药敏结果的分类一致性、小误差、重大误差和极重大误差。结果与琼脂稀释法比较,K-B法检测头孢曲松、头孢克肟、大观霉素、阿奇霉素、环丙沙星、四环素和青霉素的分类一致性分别为95.0%、76.7%、100%、80.0%、93.3%、63.3%和90.0%;所检测药物中头孢曲松、头孢克肟、环丙沙星、四环素和青霉素有小误差,分别为5.0%、23.3%、6.7%、30.0%和10.0%;对阿奇霉素和四环素的极重大误差率分别为20.0%和6.7%。结论淋病奈瑟菌监测药物除头孢克肟、阿奇霉素和四环素外,K-B法药敏试验结果的准确性较高。

Objective To evaluate the accuracy of disc diffusion method for detecting the susceptibility of Neisseria gonorrhoeae to seven surveillance drugs.Methods The agar dilution method and the disc diffusion method were compared in assessing the susceptibility of 60 N.gonorrhoeae strains to ceftriaxone,cefixime,spectinomycin,azithromycin,ciprofloxacin,tetracycline and penicillin.Comparison of results between the two methods included the categorical agreements,minor errors,major errors,and very major errors of drug susceptibility test.Results The categorical agreements of ceftriaxone,cefixime,spectinomycin,azithromycin,ciprofloxacin,tetracycline and penicillin were 95.0%,76.7%,100%,80.0%,93.3%,63.3%and 90.0%,respectively.Among the tested antibiotics,minor errors were found for ceftriaxone,cefixime,ciprofloxacin,tetracycline,and penicillin,with rates of 5.0%,23.3%,6.7%,30.0%and 10.0%,respectively.For azithromycin and tetracycline,the very major error rates were 20.0%and 6.7%,respectively.Conclusion With the exception of cefixime,azithromycin and tetracycline,the disc diffusion method is more accurate in assessing drug susceptibility of N.gonorrhoeae.