多中心评估黏菌素肉汤洗脱纸片法和黏菌素琼脂试验：来自临床和实验室标准协会的报告。
Multicenter Evaluation of Colistin Broth Disk Elution and Colistin Agar Test: a Report from the Clinical and Laboratory Standards Institute.
机构信息
Accelerate Diagnostics, Tucson Arizona, USA
Department of Pathology, University of Arizona, Tucson, Arizona, USA.
出版信息
J Clin Microbiol. 2019 Oct 23;57(11). doi: 10.1128/JCM.01269-19. Print 2019 Nov.
Susceptibility testing of the polymyxins (colistin and polymyxin B) is challenging for clinical laboratories. The Clinical and Laboratory Standards Institute (CLSI) Antimicrobial Susceptibility Testing Subcommittee evaluated two methods to enable accurate testing of these agents. These methods were a colistin broth disk elution (CBDE) and a colistin agar test (CAT), the latter of which was evaluated using two inoculum volumes, 1 μl (CAT-1) and 10 μl (CAT-10). The methods were evaluated using a collection of 270 isolates of , 122 isolates, and 106 spp. isolates. Overall, 94.4% of CBDE results were in essential agreement and 97.9% in categorical agreement (CA) with reference broth microdilution MICs. Nine very major errors (VME; 3.2%) and 3 major errors (ME; 0.9%) were observed. With the CBDE, 98.6% CA was observed for (2.5% VME, 0% ME), 99.3% CA was observed for (0% VME, 0.7% ME), and 93.1% CA was observed for spp. (5.6% VME, 3.3% ME). Overall, CA was 94.9% with 6.8% VME using CAT-1 and improved to 98.3% with 3.9% VME using CAT-10. No ME were observed using either CAT-1 or CAT-10. Using the CAT-1/CAT-10, the CA observed was 99.4%/99.7% for (1%/0.5% VME), 98.7%/100% for (8.3%/0% VME), and 88.5%/92.3% for spp. (21.4%/14.3% VME). Based on these data, the CLSI antimicrobial susceptibility testing (AST) subcommittee endorsed the CBDE and CAT-10 methods for colistin testing of and .
多黏菌素（黏菌素和多黏菌素 B）的药敏试验对临床实验室来说具有挑战性。临床和实验室标准协会（CLSI）抗微生物药敏试验分会评估了两种方法来实现这些药物的准确检测。这两种方法是黏菌素肉汤纸片洗脱法（CBDE）和黏菌素琼脂试验（CAT），后者使用两种接种量 1 μl（CAT-1）和 10 μl（CAT-10）进行评估。该方法使用 270 株 、122 株 和 106 株 分离株进行了评估。总体而言，94.4%的 CBDE 结果与参考肉汤微量稀释 MIC 具有基本一致性，97.9%具有分类一致性（CA）。观察到 9 个非常大的错误（VME；3.2%）和 3 个大错误（ME；0.9%）。使用 CBDE，观察到 98.6%的 CA 用于 （2.5% VME，0% ME），99.3%的 CA 用于 （0% VME，0.7% ME），93.1%的 CA 用于 spp.（5.6% VME，3.3% ME）。总体而言，CAT-1 的 CA 为 94.9%，VME 为 6.8%，CAT-10 的 CA 为 98.3%，VME 为 3.9%。使用 CAT-1 或 CAT-10 均未观察到 ME。使用 CAT-1/CAT-10，观察到 99.4%/99.7%的 CA 用于 （1%/0.5% VME），98.7%/100%的 CA 用于 （8.3%/0% VME），88.5%/92.3%的 CA 用于 spp.（21.4%/14.3% VME）。基于这些数据，CLSI 抗微生物药敏试验（AST）分会批准 CBDE 和 CAT-10 方法用于 和 的多黏菌素检测。
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