改良多粘菌素药敏试验培养基。
An Improved Medium for Colistin Susceptibility Testing.
机构信息
Institute of Medical Microbiology, Justus Liebig University, Giessen, Germany.
German Center for Infection Research, Partner Site Giessen-Marburg-Langen, Giessen, Germany.
出版信息
J Clin Microbiol. 2018 Apr 25;56(5). doi: 10.1128/JCM.01950-17. Print 2018 May.
The plasmid-located colistin resistance gene confers low-level resistance to colistin, a last-line antibiotic against multidrug-resistant Gram-negative bacteria. Current CLSI-EUCAST recommendations require the use of a broth microdilution (BMD) method with cation-adjusted Mueller-Hinton (CA-MH) medium for colistin susceptibility testing, but approximately 15% of all MCR-1 producers are classified as sensitive in that broth. Here we report on an improved calcium-enhanced Mueller-Hinton (CE-MH) medium that permits simple and reliable determination of -containing Colistin susceptibility testing was performed for 50 -containing and isolates, 7 intrinsically polymyxin-resistant species, and isolates with acquired resistance to polymyxins due to and mutations, respectively, and 32 -negative, colistin-susceptible isolates of , , , , , and serovar Typhimurium. A comparison of the colistin MICs determined in CA-MH medium and those obtained in CE-MH medium was performed using both the BMD and strip-based susceptibility test formats. We validated the data using an isogenic IncX4 plasmid lacking Use of the CE-MH broth provides clear separation between resistant and susceptible isolates in both BMD and gradient diffusion assays; this is true for both -containing isolates and those exhibiting either intrinsic or acquired colistin resistance. CE-MH medium is simple to prepare and overcomes current problems associated with BMD and strip-based colistin susceptibility testing, and use of the medium is easy to implement in routine diagnostic laboratories, even in resource-poor settings.
质粒定位的多粘菌素耐药基因赋予多粘菌素低度耐药性,多粘菌素是治疗多重耐药革兰氏阴性菌的最后一线抗生素。目前 CLSI-EUCAST 建议使用阳离子调整 Mueller-Hinton(CA-MH)培养基进行肉汤微量稀释(BMD)方法进行多粘菌素敏感性测试,但在该肉汤中,约 15%的所有 MCR-1 产生菌被归类为敏感菌。在这里,我们报告了一种改进的钙增强 Mueller-Hinton(CE-MH)培养基,该培养基允许简单可靠地确定含 -的多粘菌素敏感性测试。对 50 株含 -的和 株分离株、7 种固有多粘菌素耐药种、分别因 和 突变而获得对多粘菌素耐药的 和 株分离株以及 32 株 -阴性、多粘菌素敏感的 、 、 、 、 和 血清型 Typhimurium 分离株进行了测试。使用 BMD 和条带基础药敏试验格式比较了在 CA-MH 培养基中确定的多粘菌素 MIC 值与在 CE-MH 培养基中获得的 MIC 值。我们使用缺乏 的 IncX4 质粒验证了数据。CE-MH 肉汤的使用在 BMD 和梯度扩散测定中提供了抗性和敏感分离株之间的清晰分离;这对于含 -的分离株和表现出固有或获得性多粘菌素耐药性的分离株都是如此。CE-MH 培养基易于制备,克服了 BMD 和条带基础多粘菌素药敏试验中存在的问题,并且即使在资源匮乏的环境中,该培养基也易于在常规诊断实验室中实施。
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