Division of Clinical Laboratory and Blood Transfusion, University of the Ryukyus Hospital, Okinawa, Japan.
Division of Clinical Laboratory and Blood Transfusion, University of the Ryukyus Hospital, Okinawa, Japan.
J Infect Chemother. 2023 Oct;29(10):978-984. doi: 10.1016/j.jiac.2023.06.016. Epub 2023 Jul 1.
In November 2018, the European Committee for Antimicrobial Susceptibility Testing (EUCAST) established rapid antimicrobial susceptibility testing (RAST), which could be performed directly on positive blood culture samples. Although concentrations of antimicrobial agents in several antimicrobial disks available in Japan are different from those recommended by the EUCAST, the feasibility of EUCAST RAST using antimicrobial disks available in Japan remains to be evaluated.
Blood culture bottles spiked with 127 clinical isolates (65 Escherichia coli and 62 Klebsiella pneumoniae) were tested by RAST for cefotaxime (CTX), ceftazidime (CAZ), meropenem, and ciprofloxacin using antimicrobial disks available in Japan, and compared with a reference AST method using automated AST instrument (VITEK®2).
The overall category agreement (CA) for RAST using antimicrobial disks available in Japan was 96.3%, 96.8%, and 95.6% after 4, 6, and 8 h of incubations, respectively. However, the CAZ RAST for E. coli showed major error of 8.2% (8 h incubation) for the Sensi disk, 14.3% (6 h incubation), and 24.5% (8 h incubation) for the KB disk. The CTX RAST for K. pneumoniae showed 25% (4 h incubation) and 31.3% (4 h incubation) of very major error for the Sensi and KB disks, respectively.
The EUCAST RAST results for E. coli and K. pneumoniae using antimicrobial disks available in Japan suggest their usefulness, although modified RAST breakpoints are required for several antimicrobial agents.
2018 年 11 月，欧洲抗菌药物敏感性测试委员会（EUCAST）建立了快速抗菌药物敏感性测试（RAST），可以直接对阳性血培养样本进行测试。尽管日本可用的几种抗菌药物药敏纸片的抗菌药物浓度与 EUCAST 推荐的浓度不同，但仍需评估使用日本可用的抗菌药物药敏纸片进行 EUCAST RAST 的可行性。
用 127 株临床分离株（65 株大肠埃希菌和 62 株肺炎克雷伯菌）对血培养瓶进行 RAST 测试，使用日本可用的抗菌药物药敏纸片对头孢噻肟（CTX）、头孢他啶（CAZ）、美罗培南和环丙沙星进行测试，并与使用自动化 AST 仪器（VITEK®2）的参考 AST 方法进行比较。
4、6 和 8 小时孵育后，使用日本可用的抗菌药物药敏纸片进行 RAST 的总体分类符合率（CA）分别为 96.3%、96.8%和 95.6%。然而，CAZ 对大肠埃希菌的 RAST 显示 Sensi 药敏纸片有 8.2%（8 小时孵育）的主要错误，KB 药敏纸片有 14.3%（6 小时孵育）和 24.5%（8 小时孵育）。CTX 对肺炎克雷伯菌的 RAST 显示 Sensi 和 KB 药敏纸片分别有 25%（4 小时孵育）和 31.3%（4 小时孵育）的非常大错误。
使用日本可用的抗菌药物药敏纸片进行 EUCAST RAST 对大肠埃希菌和肺炎克雷伯菌的结果表明其有用性，尽管需要对几种抗菌药物进行修改后的 RAST 折点。
