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[替加环素对多重耐药不动杆菌临床分离株的体外活性。不同评价方法的比较]

[In vitro activity of tigecycline in clinical isolates of multidrug resistant Acinetobacter spp. Comparison of different methods of evaluation].

作者信息

Zárate M S, Serruto G, Smayevsky J

机构信息

Laboratorio de Microbiología, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC), Ciudad Autónoma de Buenos Aires, Argentina.

出版信息

Rev Argent Microbiol. 2010 Jan-Feb;42(1):53-6. doi: 10.1590/S0325-75412010000100012.

Abstract

Infections caused by multidrug resistant (MDRA) Acinetobacter spp. have increased worldwide. Tigecycline provides a new therapeutic option for treating these infections. We conducted a study tailored to validate an in house methodology by broth microdilution (BM) vs. commercial BM in 32 MDRA isolates. Sixty MDRA isolated in 2 time periods (2000-2003 and 2006-2008) were compared by BM, agar dilution (AD) and disk diffusion (DD) methods, as described by the CLSI and the MIC90 for each period was determined. Susceptibility was interpreted by using the breakpoints suggested by the FDA for Enterobacteriaceae. The correlation between the methodologies was performed by a scattergram, and the errors between methods were calculated. The correlation coefficients between AD and BM, and BM and DD were, r: 0.68 in both cases. For 2002-2003, the MIC90 for BM was: 1 g/ml, and for 2006-2008: 2 microg/ml. Using the FDA breakpoints for DD, we observed an unacceptable minor error (17.6%) because of false-intermediate values, considering the MIC90 was 1-2 microg/ml.

摘要

耐多药(MDRA)不动杆菌属引起的感染在全球范围内有所增加。替加环素为治疗这些感染提供了一种新的治疗选择。我们开展了一项研究,旨在通过肉汤微量稀释法(BM)与商业化BM法对比,在32株MDRA分离株中验证一种内部方法。按照CLSI所述,采用BM、琼脂稀释法(AD)和纸片扩散法(DD)对在两个时间段(2000 - 2003年和2006 - 2008年)分离出的60株MDRA进行比较,并确定每个时间段的MIC90。采用FDA针对肠杆菌科建议的折点来解释药敏结果。通过散点图对各方法之间的相关性进行分析,并计算方法间的误差。AD与BM以及BM与DD之间的相关系数,两种情况下r均为0.68。对于2002 - 2003年,BM的MIC90为:1μg/ml,对于2006 - 2008年为:2μg/ml。使用FDA针对DD的折点,鉴于MIC90为1 - 2μg/ml,我们观察到由于假中介值导致不可接受的小误差(17.6%)。

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