[Comparison of the antimicrobial susceptibility testing with three automated systems for MRSA, VISA, ESBL-producing Escherichia coli and Klebsiella pneumoniae].

Makiko Kiyosuke, Zenzo Nagasawa, Koji Kusaba, Takayuki Masaki, Hisae Yoshimura, Hiromi To, Tomoko Mitsui, Chiasa Otsubo, Chika Narita, Tsuyoko Morooka, Hiroshi Miyamoto, Ariaki Nagayama
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Abstract

Some automated systems of the identification and susceptibility for microorganisms are used and prevail in hospital laboratories. One of the most serious problems is to perform accurate susceptibility testing for low-level resistant organisms, while antibiotic resistant microbes are increasing in medical fields. To evaluate automated machines for the susceptibility testing, several antibiotic resistant organisms were examined by plural technicians in some laboratories. Each strain of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycinintermediate S. aureus (VISA), extended-spectrum β-lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae was tested by three automated systems of WalkAway, VITEK2/VITEK2 compact and Phoenix for susceptibility. The results for antibiotics generated by the systems were compared to those generated by reference methods according to CLSI guidelines. The results of WalkAway, VITEK2/VITEK2 compact, and Phoenix demonstrated 92%, 91%, and 96% of reproducibilities, 92%, 94%, and 91% of MIC agreements, 0.5%, 0.8%, and 0.3% of very major error (VME) and 0.3%, 1.4%, and 2.3% of major error (ME), respectively. All automated systems had a high reproducibility even under the performance of plural technicians, although the differences of VMEs and MEs were observed among the systems. From these data, the automated systems for antimicrobial susceptibility testing were more useful for the detection of antibiotic resistant organisms by understanding the characteristics of each system.

[MRSA、VISA、产esbl的大肠埃希菌和肺炎克雷伯菌3种自动化系统的药敏试验比较]。
一些微生物鉴定和药敏的自动化系统在医院实验室中使用和流行。在医学领域耐药微生物不断增加的情况下,如何对低水平耐药微生物进行准确的药敏试验是目前最严重的问题之一。为了评价药敏试验的自动化机器,在一些实验室由多个技术人员对几种抗生素耐药生物进行了检查。采用WalkAway、VITEK2/VITEK2 compact和Phoenix三种自动化系统检测耐甲氧西林金黄色葡萄球菌(MRSA)和万古霉素中间体金黄色葡萄球菌(VISA)、产广谱β-内酰胺酶(ESBL)的大肠杆菌和肺炎克雷伯菌的药敏。根据CLSI指南,将系统产生的抗生素结果与参考方法产生的结果进行比较。WalkAway、VITEK2/VITEK2 compact和Phoenix的重复性分别为92%、91%和96%,MIC一致性为92%、94%和91%,非常严重误差(VME)为0.5%、0.8%和0.3%,严重误差(ME)为0.3%、1.4%和2.3%。所有的自动化系统都有很高的再现性,即使在多个技术人员的表现下,尽管在系统之间观察到vme和MEs的差异。从这些数据来看,通过了解每个系统的特点,抗菌药物敏感性测试的自动化系统对抗生素耐药生物的检测更有用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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