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香港拉氏杆菌临床分离株和鱼类分离株的药敏模式:Etest法、纸片扩散法和肉汤微量稀释法的比较

Susceptibility patterns of clinical and fish isolates of Laribacter hongkongensis: comparison of the Etest, disc diffusion and broth microdilution methods.

作者信息

Lau Susanna K P, Wong Gilman K M, Poon Rosana W S, Lee Leo C K, Leung Kit-Wah, Tse Cindy W S, Ho Pak-Leung, Que Tak-Lun, Woo Patrick C Y, Yuen Kwok-Yung

机构信息

State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong.

出版信息

J Antimicrob Chemother. 2009 Apr;63(4):704-8. doi: 10.1093/jac/dkp010. Epub 2009 Feb 6.

Abstract

OBJECTIVES

To determine the antibiotic susceptibility patterns of 60 strains of Laribacter hongkongensis isolated from humans and fish to eight antibiotics and compare the results obtained from broth microdilution, Etest and disc diffusion susceptibility testing.

PATIENTS AND METHODS

The susceptibilities of 60 isolates of L. hongkongensis from humans with gastroenteritis and fish to eight antibiotics were tested by three methods [broth microdilution (reference method), Etest and disc diffusion] and their results were compared.

RESULTS

All isolates were susceptible to imipenem and ciprofloxacin by all three methods, except for one strain which was resistant to ciprofloxacin by broth microdilution. All were susceptible to ampicillin/sulbactam by Etest and disc diffusion, but eight were resistant by broth microdilution. By broth microdilution, 90%, 100%, 46.7%, 100% and 8.3% of isolates were resistant to ampicillin, ceftriaxone, cefuroxime, erythromycin and tetracycline, respectively. Although broth microdilution generally yielded higher MICs of beta-lactams, MICs obtained with Etest were in good correlation with broth microdilution for all drugs except ampicillin/sulbactam, with >90% agreement within 2 log(2) dilutions for imipenem, ciprofloxacin, erythromycin and tetracycline. Comparison of susceptibilities between broth microdilution and the other two methods showed the highest (>95%) percentage agreement for imipenem, ciprofloxacin and tetracycline. The highest discrepancies were observed with erythromycin (58.3% agreement), with an apparent increase in susceptibility by disc diffusion. A higher proportion of human isolates than fish isolates were tetracycline-resistant by all three tests (P=0.022).

CONCLUSIONS

Etest and disc diffusion appear to be reliable for evaluation of susceptibilities of L. hongkongensis to imipenem, ciprofloxacin and tetracycline. However, these methods may underestimate resistance to other beta-lactams.

摘要

目的

确定从人和鱼中分离出的60株香港海鸥菌对8种抗生素的药敏模式,并比较肉汤微量稀释法、Etest法和纸片扩散药敏试验的结果。

患者和方法

采用三种方法[肉汤微量稀释法(参考方法)、Etest法和纸片扩散法]检测60株从患有肠胃炎的人和鱼中分离出的香港海鸥菌对8种抗生素的敏感性,并比较结果。

结果

除1株菌株在肉汤微量稀释法中对环丙沙星耐药外,所有菌株在三种方法中对亚胺培南和环丙沙星均敏感。Etest法和纸片扩散法显示所有菌株对氨苄西林/舒巴坦敏感,但肉汤微量稀释法中有8株耐药。通过肉汤微量稀释法,分别有90%、100%、46.7%、100%和8.3%的菌株对氨苄西林、头孢曲松、头孢呋辛、红霉素和四环素耐药。虽然肉汤微量稀释法通常产生较高的β-内酰胺类药物最低抑菌浓度(MIC),但除氨苄西林/舒巴坦外,Etest法获得的MIC与肉汤微量稀释法对所有药物均具有良好的相关性,亚胺培南、环丙沙星、红霉素和四环素在2倍对数稀释范围内的一致性>90%。肉汤微量稀释法与其他两种方法之间的药敏比较显示,亚胺培南、环丙沙星和四环素的一致性最高(>95%)。红霉素的差异最大(一致性为58.3%),纸片扩散法显示其敏感性明显增加。在所有三项试验中,四环素耐药的人类分离株比例高于鱼类分离株(P=0.022)。

结论

Etest法和纸片扩散法似乎可可靠地评估香港海鸥菌对亚胺培南、环丙沙星和四环素的敏感性。然而,这些方法可能低估了对其他β-内酰胺类药物的耐药性。

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