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在决定使用万古霉素根除金黄色葡萄球菌时,测定实际最低抑菌浓度的必要性。

The need to assay the real MIC when making the decision to eradicate Staphylococcus aureus with vancomycin.

作者信息

Tomczak Hanna, Szałek Edyta, Błażejewska Wioleta, Myczko Katarzyna, Horla Anna, Grześkowiak Edmund

机构信息

Central Laboratory of Microbiology, University Hospital, Poznań, Poland.

出版信息

Postepy Hig Med Dosw (Online). 2013 Sep 4;67:921-5. doi: 10.5604/17322693.1065588.

Abstract

PURPOSE

The aim of the study was a comparison of the MIC (minimal inhibitory concentration) evaluated in the automatic system Vitek 2 and the real MIC of vancomycin by the Etest method for S. aureus strains isolated from clinical materials.

MATERIAL AND METHODS

Over a twelve-month study period we compared the results obtained with two commercial methods - the automatic system VITEK 2 and the real MIC by Etest - for 359 strains of S. aureus isolated from clinical materials.

RESULTS

Most of the strains of S. aureus were cultured from wounds (84), the ear (60) and nose (42). MSSA (methicillin-sensitive Staphylococcus aureus) was isolated in 342 cases and MRSA (methicillin-resistant Staphylococcus aureus) in 17 cases. The test with the Vitek automatic method showed that vancomycin had MIC values of ≤1.0 μg/ml in more than 96% and 2.0 μg/ml in over 3% of cases. Using the Etest technique MIC ≤ 1.0 μg/ml was obtained in only 16.4% of cases and values of >1.0 μg/ml in 83.6% of cases.

DISCUSSION

In view of such big differences between the MIC values obtained with the two methods the authors suggest that the Etest method of assaying the real MIC is more useful than the automatic method.

摘要

目的

本研究旨在比较采用自动系统Vitek 2评估的金黄色葡萄球菌菌株的最低抑菌浓度(MIC)与通过Etest法测定的万古霉素实际MIC,这些菌株分离自临床材料。

材料与方法

在为期十二个月的研究期间,我们比较了两种商业方法——自动系统Vitek 2和Etest法测定的实际MIC——对从临床材料中分离出的359株金黄色葡萄球菌的检测结果。

结果

大多数金黄色葡萄球菌菌株来自伤口(84株)、耳部(60株)和鼻部(42株)。甲氧西林敏感金黄色葡萄球菌(MSSA)分离出342例,耐甲氧西林金黄色葡萄球菌(MRSA)分离出17例。Vitek自动检测方法显示,超过96%的病例中万古霉素的MIC值≤1.0μg/ml,超过3%的病例中MIC值为2.0μg/ml。使用Etest技术时,仅16.4%的病例中MIC≤1.0μg/ml,83.6%的病例中MIC值>1.0μg/ml。

讨论

鉴于两种方法获得的MIC值存在如此大的差异,作者认为Etest法测定实际MIC比自动检测方法更有用。

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