用VITEK 2 AST-XN21评价头孢他啶-阿维巴坦和粘菌素的体外活性。

IF 0.7 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY
Nilgun Kansak, Neslihan Arici, Riza Adaleti, Sebahat Aksaray, Nevriye Gonullu
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引用次数: 0

摘要

背景:头孢他啶-阿维巴坦和粘菌素是治疗多重耐药菌感染的新兴抗生素。推荐用于检测粘菌素敏感性的肉汤微量稀释(BMD)试验是劳动密集型的,难以在常规条件下进行。在常规的实验室研究中,需要一种能够产生快速和可靠结果的替代方法。在我们的研究中,我们旨在比较新引入的Vitek-2 AST-XN21卡获得的结果,该卡可以同时检测头孢他啶-阿维巴坦和粘菌素的敏感性,与我们常规使用的头孢他啶-阿维巴坦圆盘扩散和Diagnostics MIC COL结果。方法:共收集60株分离株,其中耐碳青霉烯肺炎克雷伯菌51株,大肠埃希菌、铜绿假单胞菌和鲍曼不动杆菌各3株。采用MALDI-TOF质谱和Vitek-2(法国bioMerieux)系统进行菌株鉴定和药敏试验。采用纸片(10 ~ 4µg)扩散法测定头孢他啶-阿维巴坦的敏感性。在0.25 ~ 16 mg/L的稀释范围内,用Diagnostics MIC COL试剂盒研究粘菌素最低抑制浓度(MIC)。敏感性结果根据EUCAST V.14.0建议进行评价。根据ISO标准评估Vitek-2 AST-XN21试剂盒的性能。结果:经纸片扩散法检测,57株菌株中有31株对头孢他啶-阿维巴坦耐药,占54.4%。使用Diagnostics MIC COL试剂盒,60株分离株中有31株(51.7%)检测出粘菌素耐药。AST-XN21卡测定头孢他啶-阿维巴坦和粘菌素敏感性结果与头孢他啶-阿维巴坦圆盘扩散和粘菌素BMD结果分类一致(100%);没有检测到重大或非常重大的错误。由于Diagnostics MIC COL和AST-XN21试验的粘菌素BMD MIC读数限不同(16 mg/L;MIC值< 0.25 mg/L和> 8 mg/L的分离株(n = 31)的基本一致性没有比较。29株分离物的基本一致性为96.5%。结论:我们的结果表明,Vitek-2 AST-XN21检测性能良好。根据我们的数据,我们认为Vitek-2 AST-XN21试验可用于常规实验室检测头孢他啶-阿维巴坦和粘菌素耐药性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of In Vitro Activity of Ceftazidime-Avibactam and Colistin with VITEK 2 AST-XN21.

Background: Ceftazidime-avibactam and colistin are antibiotics of new and regaining importance used for the treatment of infections caused by multidrug-resistant organisms. The broth microdilution (BMD) test recommended for detecting colistin sensitivity is labor-intensive and difficult to perform under routine conditions. There is a need for alternative methods that produce fast and reliable results in routine laboratory studies. In our study, we aimed to compare the results obtained with the newly introduced Vitek-2 AST-XN21 cards, which allow the detection of ceftazidime-avibactam and colistin sensitivity simultaneously, with the ceftazidime-avibactam disk diffusion and Diagnostics MIC COL results that we use routinely.

Methods: A total of 60 isolates, including 51 carbapenem-resistant Klebsiella pneumoniae and three each of Echerichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii isolated from various clinical samples, were included in the study. Identification of strains and antibiotic susceptibility tests were performed with MALDI-TOF MS and Vitek-2 (bioMerieux, France) system. Ceftazidime-avibactam sensitivity was determined by disk (10 - 4 µg) diffusion method. Colistin minimum inhibitory concentration (MIC) was studied with the Diagnostics MIC COL kit at a dilution range of 0.25 - 16 mg/L. Susceptibility results were evaluated according to EUCAST V.14.0 recommendations. The performance of the Vitek-2 AST-XN21 kit was evaluated according to ISO criteria.

Results: By disk diffusion method, 31 of 57 isolates (54.4%) were found resistant to ceftazidime-avibactam. With the Diagnostics MIC COL kit, 31 of 60 isolates (51.7%) were detected as colistin resistant. Ceftazidime-avibactam and colistin sensitivity results determined by the AST-XN21 card were found to be categorically compatible with the ceftazidime-avibactam disk diffusion and colistin BMD results (100%); no major or very major errors were detected. Since the colistin BMD MIC reading limits of the Diagnostics MIC COL and AST-XN21 tests are different (16 mg/L; 8 mg/L), the essential agreement for isolates (n = 31) with MIC values < 0.25 mg/L and > 8 mg/L were not compared. The essential agreement for the evaluated 29 isolates was found to be 96.5%.

Conclusions: Our results showed that the performance of the Vitek-2 AST-XN21 test was good. According to our data, we believe that the Vitek-2 AST-XN21 test can be used in routine laboratories for the detection of ceftazidime-avibactam and colistin resistance.

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来源期刊
Clinical laboratory
Clinical laboratory 医学-医学实验技术
CiteScore
1.50
自引率
0.00%
发文量
494
审稿时长
3 months
期刊介绍: Clinical Laboratory is an international fully peer-reviewed journal covering all aspects of laboratory medicine and transfusion medicine. In addition to transfusion medicine topics Clinical Laboratory represents submissions concerning tissue transplantation and hematopoietic, cellular and gene therapies. The journal publishes original articles, review articles, posters, short reports, case studies and letters to the editor dealing with 1) the scientific background, implementation and diagnostic significance of laboratory methods employed in hospitals, blood banks and physicians'' offices and with 2) scientific, administrative and clinical aspects of transfusion medicine and 3) in addition to transfusion medicine topics Clinical Laboratory represents submissions concerning tissue transplantation and hematopoietic, cellular and gene therapies.
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