Menozzi Maria Grazia, Eigner Ulrich, Covan Silvia, Rossi Sabina, Somenzi Pietro, Dettori Giuseppe, Chezzi Carlo, Fahr Anne-Marie
Section of Microbiology, Department of Pathology and Laboratory Medicine, University of Parma, Viale Antonio Gramsci, 14, 43100 Parma, Italy.
J Clin Microbiol. 2006 Nov;44(11):4085-94. doi: 10.1128/JCM.00614-06. Epub 2006 Sep 27.
The performance of the BD Phoenix Automated Microbiology System (BD Diagnostic Systems, Sparks, MD) was assessed for identification (ID) and antimicrobial susceptibility testing (AST) of the majority of clinically encountered bacterial isolates in a European collaborative two-center trial. A total of 494 bacterial isolates including various species of the Enterobacteriaceae and 110 nonfermentative gram-negative bacteria were investigated: of these, 385 were single patient isolates, and 109 were challenge strains tested at one center. The performance of the Phoenix extended-spectrum beta-lactamase (ESBL) test was also evaluated for 203 strains of Escherichia coli, Klebsiella pneumoniae, and Klebsiella oxytoca included in the study. Forty-two antimicrobial drugs were tested, including members of the following drug classes: aminoglycosides, beta-lactam antibiotics, beta-lactam/beta-lactamase inhibitors, carbapenems, cephems, monobactams, folate antagonists, quinolones, and others. Phoenix system ID results were compared to those of the laboratories' routine ID systems (API 20E and API CHE, ATB ID32E, ID32GN, and VITEK 2 [bioMérieux, Marcy l'Etoile, France]); Phoenix AST results were compared to those of frozen standard broth microdilution (SBM) panels according to NCCLS (now CLSI) guidelines (NCCLS document M100-S9, approved standard M7-A4). Discrepant results were repeated in duplicate. Concordant IDs of 98.4 and 99.1% were observed for the Enterobacteriaceae and the nonfermentative group, respectively. For AST results, the overall essential agreement was 94.2%; the category agreement was 97.3%; and the very major error rate, major error rate, and minor error rate were 1.6, 0.6, and 1.9%, respectively. In terms of ESBL detection, Phoenix results were 98.5% concordant with those of the reference system, with 98.0% sensitivity and 98.7% specificity. In conclusion, the Phoenix ID results showed high agreement with results of the systems to which they were being compared: the AST performance was highly equivalent to that of the SBM reference method, and the system proved to be very accurate for the detection of ESBL producers.
在一项欧洲多中心合作试验中，对BD Phoenix全自动微生物分析系统（BD诊断系统公司，美国马里兰州斯帕克斯）针对大多数临床常见细菌分离株的鉴定（ID）和药敏试验（AST）性能进行了评估。共研究了494株细菌分离株，包括肠杆菌科的各种菌种以及110株非发酵革兰氏阴性菌：其中，385株为单一患者分离株，109株为在一个中心检测的挑战菌株。还对研究中包含的203株大肠埃希菌、肺炎克雷伯菌和产酸克雷伯菌进行了Phoenix超广谱β-内酰胺酶（ESBL）试验性能评估。测试了42种抗菌药物，包括以下药物类别的成员：氨基糖苷类、β-内酰胺类抗生素、β-内酰胺/β-内酰胺酶抑制剂、碳青霉烯类、头孢菌素类、单环β-内酰胺类、叶酸拮抗剂、喹诺酮类等。将Phoenix系统的ID结果与实验室常规ID系统（API 20E和API CHE、ATB ID32E、ID32GN以及VITEK 2[法国梅里埃公司，马西耶图瓦勒]）的结果进行比较；将Phoenix AST结果与根据美国国家临床实验室标准委员会（现为美国临床和实验室标准协会）指南（NCCLS文件M100-S9，批准标准M7-A4）制备的冷冻标准肉汤稀释法（SBM）平板的结果进行比较。对不一致的结果进行了重复检测。肠杆菌科和非发酵菌组的ID一致性分别为98.4%和99.1%。对于AST结果，总体基本一致性为94.2%；类别一致性为97.3%；极重大错误率、重大错误率和微小错误率分别为1.6%、0.6%和1.9%。在ESBL检测方面，Phoenix结果与参考系统的结果一致性为98.5%，敏感性为98.0%，特异性为98.7%。总之，Phoenix的ID结果与所比较系统的结果高度一致：AST性能与SBM参考方法高度等效，并且该系统在检测产ESBL菌方面非常准确。
