Institute for Laboratory and Transfusion Medicine, Heart and Diabetes Center NRW, University Hospital of the Ruhr-University Bochum, Bad Oeynhausen, Germany.
Antimicrob Agents Chemother. 2013 Oct;57(10):4761-8. doi: 10.1128/AAC.00863-13. Epub 2013 Jul 15.
In recent decades, Acinetobacter baumannii has emerged as an organism of great concern due to its ability to accumulate antibiotic resistance. In order to improve the diagnosis of resistance determinants in A. baumannii in terms of lead time and accuracy, we developed a microarray that can be used to detect 91 target sequences associated with antibiotic resistance within 4 h from bacterial culture to result. The array was validated with 60 multidrug-resistant strains of A. baumannii in a blinded, prospective study. The results were compared to phenotype results determined by the automated susceptibility testing system VITEK2. Antibiotics considered were piperacillin-tazobactam, ceftazidime, imipenem, meropenem, trimethoprim-sulfamethoxazole, amikacin, gentamicin, tobramycin, ciprofloxacin, and tigecycline. The average positive predictive value, negative predictive value, sensitivity, and specificity were 98, 98, 99, and 94%, respectively. For carbapenemase genes, the array results were compared to singleplex PCR results provided by the German National Reference Center for Gram-Negative Pathogens, and results were in complete concordance. The presented array is able to detect all relevant resistance determinants of A. baumannii in parallel. The short handling time of 4 h from culture to result helps to provide fast results in order to initiate adequate anti-infective therapy for critically ill patients. Another application would be data acquisition for epidemiologic surveillance.
在过去的几十年中，鲍曼不动杆菌因其能够积累抗生素耐药性而成为一个备受关注的生物体。为了提高鲍曼不动杆菌耐药决定因素的诊断及时性和准确性，我们开发了一种微阵列，可以在 4 小时内从细菌培养物中检测到与抗生素耐药性相关的 91 个目标序列。该阵列在一项盲法、前瞻性研究中用 60 株多药耐药鲍曼不动杆菌进行了验证。结果与自动药敏测试系统 VITEK2 确定的表型结果进行了比较。考虑的抗生素有哌拉西林-他唑巴坦、头孢他啶、亚胺培南、美罗培南、复方磺胺甲噁唑、阿米卡星、庆大霉素、妥布霉素、环丙沙星和替加环素。平均阳性预测值、阴性预测值、敏感性和特异性分别为 98%、98%、99%和 94%。对于碳青霉烯酶基因，微阵列的结果与德国革兰氏阴性病原体国家参考中心提供的单重 PCR 结果进行了比较，结果完全一致。所提出的微阵列能够同时平行检测鲍曼不动杆菌的所有相关耐药决定因素。从培养到结果的 4 小时短处理时间有助于快速提供结果，以便为重症患者启动适当的抗感染治疗。另一个应用是进行流行病学监测的数据采集。
