在从尿路感染患者分离出的微生物中，两种纸片扩散法和最低抑菌浓度法测定抗生素耐药性的结果具有一致性。

The consistency of antibiotic resistance' results in two methods of disk diffusion and MIC in isolated organisms from patients with urinary tract infections.

作者信息

Karami A, Mazloom Zadeh S, Rastin A, Karami A, Shiri P

机构信息

Infectious Disease Department, Zanjan University of Medical Sciences, Zanjan, Iran.

Epidemiology Department, Zanjan University of Medical Sciences, Zanjan, Iran.

出版信息

J Med Life. 2015;8(Spec Iss 4):282-286.

PMID:28316745

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5319302/

Abstract

The urinary tract infection is the most common infection and drug resistance to it is increasing. Due to the acute infection, the prescribing of medicine is conducted before culture and antibiogram and according to the results, disk diffusion is adjusted. The aim of this study was to compare it with MIC to determine to what extent the current method could be useful. This descriptive cross-sectional investigation research regarding drug resistance was conducted with the help of two methods of disk diffusion and MIC on the isolations of patients' urine culture with UTI (midstream clean catch). Bacterial resistance was measured, and sensitivity and specificity were evaluated. The MIC method was considered the gold standard and, according to the related formula, the sensitivity and specificity of disk diffusion were related to 13 antibiotics obtained as it follows: ciprofloxacin 69% and 69.1% (0.0001 > p and Kappa = .292), cotrimoxazole 50% and 77.3% (p = 0.010), nitrofurantoin 84.7% and 58.2% (0.0001 > p and Kappa = 0.44), ampicilin 83.3% and 85.3% (0.0001 > p and Kappa = 0.33), ofloxacin 65.5% and 83.9% (0.0001 > p and Kappa = 0.429), cephalexin 46.2% and 75.2% (p = 0.012 and Kappa = 0.116), gentamicin 64.2% and 66% (0.0001 > p and Kappa = 0.276), ceftriaxone 27.6% and 80.9% (p = 0.216 and Kappa = 0.074), nalidixic acid 42.1% and 89.2% (0.0001 > p and Kappa = 0.354), imipenem 63.4% and 70.4% (0.0001 > p and Kappa 0.306), co-amoxiclav 83% and 71% (0.0001 > p and Kappa = 0.412), cefixime 21% and 80.9% (0.0001 > p and Kappa = 0.412), vancomycin 55.9% and 94.7 (0.9001 > p and Kappa = 0.532). Sensitivity and specificity of this method were reported to be lower than MIC. Due to the low sensitivity and specificity of the disk diffusion method, antibiotic therapy should be certainly considered in clinical conditions, and risk factors for the infection and only by this approach cannot prescribe the drug.

摘要

尿路感染是最常见的感染，且对其的耐药性正在增加。由于急性感染，在进行培养和药敏试验之前就开始用药，并根据结果调整纸片扩散法。本研究的目的是将其与最低抑菌浓度（MIC）进行比较，以确定当前方法的有用程度。这项关于耐药性的描述性横断面调查研究借助纸片扩散法和MIC这两种方法，对尿路感染（清洁中段尿）患者尿液培养分离菌进行研究。测量细菌耐药性，并评估敏感性和特异性。MIC方法被视为金标准，根据相关公式，纸片扩散法的敏感性和特异性与13种抗生素相关，结果如下：环丙沙星为69%和69.1%（0.0001＞p，Kappa = 0.292），复方新诺明为50%和77.3%（p = 0.010），呋喃妥因为84.7%和58.2%（0.0001＞p，Kappa = 0.44），氨苄西林为83.3%和85.3%（0.0001＞p，Kappa = 0.33），氧氟沙星为65.5%和83.9%（0.0001＞p，Kappa = 0.429），头孢氨苄为46.2%和75.2%（p = 0.012，Kappa = 0.116），庆大霉素为64.2%和66%（0.0001＞p，Kappa = 0.276），头孢曲松为27.6%和80.9%（p = 0.216，Kappa = 0.074），萘啶酸为42.1%和89.2%（0.0001＞p，Kappa = 0.354），亚胺培南为63.4%和70.4%（0.0001＞p，Kappa 0.306），阿莫西林克拉维酸为83%和71%（0.0001＞p，Kappa = 0.412），头孢克肟为21%和80.9%（0.0001＞p，Kappa = 0.412），万古霉素为55.9%和94.7（0.9001＞p，Kappa = 0.532）。据报道，该方法的敏感性和特异性低于MIC。由于纸片扩散法的敏感性和特异性较低，在临床情况下肯定应考虑抗生素治疗，且仅通过这种方法不能确定用药，还需考虑感染的危险因素。