Kiyosuke Makiko, Nagasawa Zenzo, Kusaba Koji, Masaki Takayuki, Yoshimura Hisae, To Hiromi, Mitsui Tomoko, Otsubo Chiasa, Narita Chika, Morooka Tsuyoko, Miyamoto Hiroshi, Nagayama Ariaki
The Kyushu Drug-Resistant Bacteria Testing-Network, Japan.
Rinsho Biseibutshu Jinsoku Shindan Kenkyukai Shi. 2010;21(1):1-11.
Some automated systems of the identification and susceptibility for microorganisms are used and prevail in hospital laboratories. One of the most serious problems is to perform accurate susceptibility testing for low-level resistant organisms, while antibiotic resistant microbes are increasing in medical fields. To evaluate automated machines for the susceptibility testing, several antibiotic resistant organisms were examined by plural technicians in some laboratories. Each strain of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycinintermediate S. aureus (VISA), extended-spectrum β-lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae was tested by three automated systems of WalkAway, VITEK2/VITEK2 compact and Phoenix for susceptibility. The results for antibiotics generated by the systems were compared to those generated by reference methods according to CLSI guidelines. The results of WalkAway, VITEK2/VITEK2 compact, and Phoenix demonstrated 92%, 91%, and 96% of reproducibilities, 92%, 94%, and 91% of MIC agreements, 0.5%, 0.8%, and 0.3% of very major error (VME) and 0.3%, 1.4%, and 2.3% of major error (ME), respectively. All automated systems had a high reproducibility even under the performance of plural technicians, although the differences of VMEs and MEs were observed among the systems. From these data, the automated systems for antimicrobial susceptibility testing were more useful for the detection of antibiotic resistant organisms by understanding the characteristics of each system.
一些用于微生物鉴定和药敏试验的自动化系统在医院实验室中得到应用并盛行。最严重的问题之一是对低水平耐药菌进行准确的药敏试验，而在医学领域抗生素耐药微生物正在增加。为了评估用于药敏试验的自动化仪器，一些实验室的多名技术人员对几种抗生素耐药菌进行了检测。耐甲氧西林金黄色葡萄球菌（MRSA）、万古霉素中介金黄色葡萄球菌（VISA）、产超广谱β-内酰胺酶（ESBL）的大肠埃希菌和肺炎克雷伯菌的每个菌株，通过WalkAway、VITEK2/VITEK2 compact和Phoenix这三种自动化系统进行药敏试验。将这些系统生成的抗生素结果与根据CLSI指南的参考方法生成的结果进行比较。WalkAway、VITEK2/VITEK2 compact和Phoenix的结果分别显示重复性为92%、91%和96%，MIC一致性为92%、94%和91%，极重大误差（VME）为0.5%、0.8%和0.3%，重大误差（ME）为0.3%、1.4%和2.3%。尽管各系统之间观察到VME和ME存在差异，但即使在多名技术人员操作的情况下，所有自动化系统都具有较高的重复性。从这些数据来看，通过了解每个系统的特点，抗菌药敏试验自动化系统在检测抗生素耐药菌方面更有用。
