Singh Vikram, Bala Manju, Kakran Monika, Ramesh V
Apex Regional STD Teaching, Training & Research Centre, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
BMJ Open. 2012 Jul 2;2(4). doi: 10.1136/bmjopen-2012-000969. Print 2012.
A variety of techniques are available for antimicrobial susceptibility testing of Neisseria gonorrhoeae.
The aim of this study was to find a cost-effective, reliable and easily applicable microbiological method to detect antimicrobial susceptibilities of N. gonorrhoeae in resource-poor countries.
Prospective study.
Male and female STD clinic of Regional STD Teaching, Training and Research Centre, New Delhi, India.
N. gonorrhoeae isolates from all male and female patients presenting with acute gonococcal urethritis and cervical discharge.
A total of 295 consecutive N. gonorrhoeae isolates during 2005-2010 was used to compare the Clinical and Laboratory Standards Institute (CLSI) and CDS disc diffusion technique with Etest by performing antimicrobial susceptibility testing in parallel for penicillin, tetracycline, ceftriaxone, ciprofloxacin and spectinomycin. WHO reference strains were used as controls.
CDS disc diffusion zones of inhibition showed that complete percentage agreement for penicillin, ciprofloxacin and tetracycline was high with their analogous Etest minimal inhibitory concentrations in comparison to CLSI disc diffusion technique, that is, 91.5%, 92.9% and 99.3% versus 87.5%, 88.5% and 74.9%, respectively. CDS results had less number of major and minor category discrepancies in comparison to CLSI and CDS method showed excellent correlation coefficient (r=1) with Etest for all five antimicrobial agents tested in comparison to CLSI (r=0.92). It was very poor (r=0.61) by CLSI method for tetracycline. The correlation coefficients between the two methods and the Etest were identical if tetracycline was removed from the CLSI analysis.
The CDS technique is an attractive alternative for N. gonorrhoeae susceptibility testing and is recommended for monitoring the antimicrobial susceptibility in less developed and resource-poor settings to facilitate enhanced antimicrobial resistance surveillance when the WHO Gonococcal Antimicrobial Surveillance Programme is undergoing expansion to meet the ongoing challenges of surveillance and control of gonococcal antimicrobial resistance.
有多种技术可用于淋病奈瑟菌的抗菌药物敏感性试验。
本研究的目的是找到一种经济有效、可靠且易于应用的微生物学方法，以检测资源匮乏国家中淋病奈瑟菌的抗菌药物敏感性。
前瞻性研究。
印度新德里地区性传播疾病教学、培训与研究中心的男女性病诊所。
所有出现急性淋菌性尿道炎和宫颈分泌物的男性和女性患者的淋病奈瑟菌分离株。
2005年至2010年期间共收集了295株连续的淋病奈瑟菌分离株，通过对青霉素、四环素、头孢曲松、环丙沙星和壮观霉素进行平行抗菌药物敏感性试验，比较临床和实验室标准协会（CLSI）和CDS纸片扩散技术与Etest法。使用世界卫生组织参考菌株作为对照。
CDS纸片扩散抑菌圈显示，与CLSI纸片扩散技术相比，青霉素、环丙沙星和四环素的完全百分比一致性与其类似的Etest最低抑菌浓度较高，即分别为91.5%、92.9%和99.3%，而CLSI分别为87.5%、88.5%和74.9%。与CLSI相比，CDS结果的主要和次要类别差异数量较少，并且CDS法与Etest法对所有五种测试抗菌药物的相关系数极佳（r = 1），而CLSI法对四环素的相关系数非常低（r = 0.61）。如果从CLSI分析中去除四环素，则两种方法与Etest法之间的相关系数相同。
CDS技术是淋病奈瑟菌药敏试验的一种有吸引力的替代方法，推荐用于欠发达和资源匮乏地区的抗菌药物敏感性监测，以便在世界卫生组织淋病抗菌药物监测计划正在扩大以应对淋病抗菌药物耐药性监测和控制的持续挑战时，促进加强抗菌药物耐药性监测。
