Alfouzan Wadha, Al-Enezi Tahani, AlRoomi Ebteehal, Sandhya Vayalil, Chandy Rachel, Khan Zia Uddin
Microbiology Unit, Department of Laboratories, Farwania Hospital, Kuwait; Department of Microbiology, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait.
Microbiology Unit, Department of Laboratories, Farwania Hospital, Kuwait.
Rev Iberoam Micol. 2017 Jul-Sep;34(3):171-174. doi: 10.1016/j.riam.2016.12.002. Epub 2017 Jun 13.
Candida species are part of the normal human microbiota. However, in recent years, nosocomial bloodstream Candida infections have emerged as a significant problem ranking the fourth common cause of fungemia in intensive care units. Although microdilution methods are the ones recommended for susceptibility testing, they are difficult to undertake in the clinical practice. Thus, an automated commercially available test is ideal.
To compare minimum inhibitory concentrations (MICs) obtained with the recently introduced Vitek 2 yeast susceptibility system card (AST-YS01) with Etest.
263 clinical Candida isolates representing six species were included in the study. Categorical agreements (CA) were assessed as described elsewhere.
Irrespective of the Candida species tested, the overall CA between Vitek 2 and Etest ranged between 66.7% and 100%. In general, Etest yielded lower MICs than Vitek 2. For Candida albicans, the CA between Vitek 2 and Etest was >95% for amphotericin B, voriconazole and flucytosine, but only 89% for fluconazole. With respect to Candida glabrata, the CA was between 97% and 100%. The major errors were with Candida krusei and flucytosine and Candida kefyr and amphotericin B. Candida tropicalis susceptibility for fluconazole by Vitek 2 reported more SDD and resistant strains than Etest. Candida parapsilosis showed 100% CA against all the four antifungals tested. No very major errors were detected between the two methods.
Vitek 2 provided comparable results to Etest with quick turnaround for the testing of Candida species susceptibilities.
念珠菌属是人类正常微生物群的一部分。然而，近年来，医院获得性念珠菌血流感染已成为一个重大问题，在重症监护病房中是真菌血症的第四大常见病因。尽管微量稀释法是推荐用于药敏试验的方法，但在临床实践中难以实施。因此，一种自动化的商用检测方法是理想的。
比较最近推出的Vitek 2酵母药敏系统卡（AST-YS01）与Etest法所获得的最低抑菌浓度（MIC）。
本研究纳入了代表六种念珠菌的263株临床分离株。分类一致性（CA）的评估方法如其他文献所述。
无论检测的念珠菌种类如何，Vitek 2和Etest之间的总体CA在66.7%至100%之间。一般来说，Etest法得出的MIC低于Vitek 2法。对于白色念珠菌，Vitek 2和Etest之间对于两性霉素B、伏立康唑和氟胞嘧啶的CA>95%，但对于氟康唑仅为89%。对于光滑念珠菌，CA在97%至100%之间。主要误差出现在克柔念珠菌与氟胞嘧啶以及高加索念珠菌与两性霉素B之间。Vitek 2法报告的热带念珠菌对氟康唑的敏感性中，敏感性降低和耐药菌株比Etest法更多。近平滑念珠菌对所有四种测试抗真菌药物的CA均为100%。两种方法之间未检测到非常大的误差。
Vitek 2在检测念珠菌属药敏方面提供了与Etest相当的结果，且周转时间快。
