Rennie Robert P, Brosnikoff Cheryl, Shokoples Sandy, Reller L Barth, Mirrett Stanley, Janda William, Ristow Kathy, Krilcich Ann
Medical Microbiology Laboratory, University of Alberta Hospital, Edmonton, AB, Canada.
J Clin Microbiol. 2008 Aug;46(8):2681-5. doi: 10.1128/JCM.00449-08. Epub 2008 Jun 25.
The new Neisseria-Haemophilus identification (NH) card for Vitek 2 was compared with 16S rRNA gene sequencing (16S) as the reference method for accurate identification of Neisseria spp., Haemophilus spp., and other fastidious gram-negative bacteria. Testing was performed on the Vitek 2 XL system with modified software at three clinical trial laboratories. Reproducibility was determined with nine ATCC quality control strains tested 20 times over a minimum of 10 days at all three sites. A challenge set of 30 strains with known identifications and 371 recent fresh and frozen clinical isolates were also tested. Expected positive and negative biochemical reactions were also evaluated for substrate reproducibility. All microorganisms were tested on the NH card, and all clinical and stock isolates were saved for 16S testing. All reproducibility tests yielded expected results within a 95% confidence interval. For challenge microorganisms, there was 98% overall correct identification, including 8% low discrimination, 2% incorrect identification, and 0% unidentified. For clinical strains, there was 96.5% overall correct identification, including 10.2% low discrimination, 2.7% incorrect identification, and 0.8% unidentified. The 2.7% (10/371) of clinical isolates that gave an incorrect identification consisted of 7 isolates correct to genus and 3 strains incorrect to genus. There were an additional 27 strains (primarily Neisseria species) for which the 16S identification result was different from the NH card result. These were all unclaimed species by the system. The new NH card met all performance criteria within a 95% confidence interval compared to identification of clinical isolates by 16S.
将用于Vitek 2的新型奈瑟菌-嗜血杆菌鉴定(NH)卡与16S rRNA基因测序(16S)进行比较,后者作为准确鉴定奈瑟菌属、嗜血杆菌属及其他苛养革兰氏阴性菌的参考方法。在三个临床试验实验室使用改良软件的Vitek 2 XL系统上进行测试。通过在所有三个地点对9株ATCC质量控制菌株进行至少10天、共20次的测试来确定重现性。还对一组已知鉴定结果的30株菌株以及371株近期新鲜和冷冻的临床分离株进行了测试。还评估了预期的阳性和阴性生化反应的底物重现性。所有微生物均在NH卡上进行测试,所有临床和储备分离株均留存用于16S测试。所有重现性测试均在95%置信区间内得出预期结果。对于挑战性微生物,总体正确鉴定率为98%,包括8%的低鉴别率、2%的错误鉴定率和0%的未鉴定率。对于临床菌株,总体正确鉴定率为96.5%,包括10.2%的低鉴别率、2.7%的错误鉴定率和0.8%的未鉴定率。给出错误鉴定结果的2.7%(10/371)临床分离株中,有7株属鉴定正确,3株属鉴定错误。另外还有27株(主要是奈瑟菌属物种),其16S鉴定结果与NH卡结果不同。这些都是该系统未识别的物种。与通过16S鉴定临床分离株相比,新型NH卡在95%置信区间内满足所有性能标准。