Juretschko Stefan, Labombardi Vincent J, Lerner Stephen A, Schreckenberger Paul C
Arkansas Children's Hospital, 800 Marshall Street, Little Rock, AR 72202, USA.
J Clin Microbiol. 2007 Apr;45(4):1339-42. doi: 10.1128/JCM.01716-06. Epub 2007 Jan 17.
Contemporary clinical isolates and challenge strains of Pseudomonas aeruginosa were tested by four automated susceptibility testing systems (BD Phoenix, MicroScan WalkAway, Vitek, and Vitek 2; two laboratories with each) against six broad-spectrum beta-lactams, and the results were compared to reference broth microdilution (BMD) and to consensus results from three validated methods (BMD, Etest [AB Biodisk, Solna, Sweden], and disk diffusion). Unacceptable levels of error (minor, major, and very major) were detected, some with systematic biases toward false susceptibility (piperacillin-tazobactam and imipenem) and others toward false resistance (aztreonam, cefepime, and ceftazidime). We encourage corrective action by the system manufacturers to address test biases, and we suggest that clinical laboratories using automated systems should consider accurate alternative methods for routine use.
采用四种自动化药敏测试系统（BD Phoenix、MicroScan WalkAway、Vitek和Vitek 2；每个系统在两个实验室进行测试）对当代铜绿假单胞菌临床分离株和攻击株进行六种广谱β-内酰胺类药物的测试，并将结果与参考肉汤微量稀释法（BMD）以及三种验证方法（BMD、Etest [AB Biodisk，瑞典索尔纳]和纸片扩散法）的一致结果进行比较。检测到了不可接受的误差水平（小误差、大误差和非常大误差），其中一些对假敏感存在系统偏差（哌拉西林-他唑巴坦和亚胺培南），另一些则对假耐药存在系统偏差（氨曲南、头孢吡肟和头孢他啶）。我们鼓励系统制造商采取纠正措施以解决测试偏差，并且建议使用自动化系统的临床实验室应考虑采用准确的替代方法用于常规检测。
