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[阿贝卡星、万古霉素和替考拉宁对耐甲氧西林金黄色葡萄球菌的纸片扩散药敏试验的可靠性]

[Reliability of disc-diffusion susceptibility testing for arbekacin, vancomycin and teicoplanin against methicillin-resistant Staphylococcus aureus].

作者信息

Kouda M, Homma S, Udagawa I, Tamura K, Fukuhara J, Takeuchi M

机构信息

First Division of Clinical Laboratories, Tokyo Metropolitan Police Hospital.

出版信息

Jpn J Antibiot. 1999 Dec;52(12):681-9.

Abstract

We investigated the differences in judgments among four disc-diffusion methods on susceptibility testing of arbekacin (ABK), vancomycin (VCM) and teicoplanin (TEIC) against 37 strains of methicillin-resistant Staphylococcus aureus (MRSA). These results were compared with minimum inhibitory concentrations (MICs) obtained from micro broth-dilution method. A marked difference was noted in the judgment of susceptibility to TEIC in Tri-disc method, that is 2 strains (5.4%) fell into sensitive (+3) 34 strains (91.9%) into moderately sensitive (+2) and 1 strain (2.7%) into moderately resistant (+), while in Sensi-disc method all strains fell into sensitive (S). According to the MICs, no strain of the MRSA tested revealed resistance to ABK, VCM and TEIC. Consequently, these three antimicrobial agents were thought to be effective on MRSA infections. From these results, we concluded that Tri-disc method for glycopeptide against MRSA, especially for TEIC, is not recommendable as a disc-diffusion method in susceptibility testing.

摘要

我们研究了四种纸片扩散法在对37株耐甲氧西林金黄色葡萄球菌(MRSA)进行阿贝卡星(ABK)、万古霉素(VCM)和替考拉宁(TEIC)药敏试验时判断结果的差异。将这些结果与微量肉汤稀释法获得的最低抑菌浓度(MIC)进行比较。在三联纸片法中,对TEIC药敏的判断存在显著差异,即2株(5.4%)为敏感(+3),34株(91.9%)为中度敏感(+2),1株(2.7%)为中度耐药(+),而在敏感纸片法中所有菌株均为敏感(S)。根据MIC结果,所检测的MRSA菌株对ABK、VCM和TEIC均未显示耐药。因此,认为这三种抗菌药物对MRSA感染有效。从这些结果来看,我们得出结论,在药敏试验中,针对MRSA的糖肽类药物(尤其是TEIC)的三联纸片法作为一种纸片扩散法是不可取的。

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