Bonapace C R, White R L, Friedrich L V, Bosso J A
Anti-Infective Research Laboratory, College of Pharmacy, Medical University of South Carolina, Charleston, South Carolina, USA.
Diagn Microbiol Infect Dis. 2000 Sep;38(1):43-50. doi: 10.1016/s0732-8893(00)00163-2.
Acinetobacter baumannii is becoming increasingly resistant to antibiotics, often requiring combination therapy. Numerous methods exist to detect the presence of in vitro synergy with the time-kill and checkerboard tests being widely used. The Epsilometer test (E test) is a new method that is less labor intensive, but has not been evaluated using a wide range of antimicrobials and organisms. We assessed synergy using the time-kill and checkerboard tests and compared the results to the E test method using 10 clinical isolates of A. baumannii. Antimicrobial combinations evaluated consisted of trovafloxacin or tobramycin in combination with cefepime or piperacillin. Synergy was detected with all combinations by either the checkerboard or time-kill method. Synergy was not detected by the Etest method. The agreement between the time-kill test and Etest method was 72% (range 42-97%); for the time-kill and checkerboard tests, agreement was 51% (range 30-67%). The Etest method appears promising although further testing should be performed with additional antimicrobial agents and organisms.
鲍曼不动杆菌对抗生素的耐药性日益增强，常常需要联合治疗。有多种方法可用于检测体外协同作用，其中时间杀菌试验和棋盘法被广泛应用。E试验是一种新方法，劳动强度较低，但尚未使用多种抗菌药物和微生物进行评估。我们使用时间杀菌试验和棋盘法评估了协同作用，并将结果与使用10株鲍曼不动杆菌临床分离株的E试验方法进行了比较。评估的抗菌药物组合包括曲伐沙星或妥布霉素与头孢吡肟或哌拉西林联合使用。通过棋盘法或时间杀菌法在所有组合中均检测到协同作用。E试验方法未检测到协同作用。时间杀菌试验与E试验方法之间的一致性为72%（范围42%-97%）；时间杀菌试验与棋盘法之间的一致性为51%（范围30%-67%）。E试验方法似乎很有前景，不过应该使用更多的抗菌药物和微生物进行进一步测试。
