Siddiqi S H, Hawkins J E, Laszlo A
J Clin Microbiol. 1985 Dec;22(6):919-23. doi: 10.1128/jcm.22.6.919-923.1985.
A total of 224 recent isolates of Mycobacterium tuberculosis from 163 patients selected to have multidrug resistance were tested against streptomycin (SM), isoniazid, rifampin, and ethambutol (EMB) by the rapid radiometric BACTEC method and two conventional proportion methods: the World Health Organization (WHO) method, using Lowenstein-Jensen medium; and the Veterans Administration reference laboratory for mycobacteria (VA) method, using Middlebrook 7H10 agar medium. The results were compared, focusing on the concentrations of the drugs in all three methods. Among the four drugs tested, most of the discrepancies in measured activity were observed with SM and EMB, generally because of differences in the drug concentrations used by the three methods. A 4-micrograms amount of SM in the BACTEC method was found to be slightly less active than 10 micrograms in the VA method and significantly more active than 4 micrograms of dihydrostreptomycin in the WHO method. With EMB, 2.5 micrograms in BACTEC was similar to 5 micrograms in the VA method and 2 micrograms in the WHO method, while 10 micrograms in the BACTEC method was found to be more active than 10 and 2 micrograms in the VA and WHO methods, respectively. To attain close agreement, drug concentrations used in the BACTEC method should be carefully selected when a comparison is to be made with any conventional method employed in a laboratory. Standardization of in vitro susceptibility testing is greatly needed to achieve uniformity among the test methods used to evaluate tuberculosis therapeutics.
共对从163例被选患有多重耐药性的患者中分离出的224株近期结核分枝杆菌进行了检测，采用快速放射性BACTEC方法以及两种传统比例法，即世界卫生组织（WHO）方法（使用罗-琴培养基）和退伍军人事务部分枝杆菌参考实验室（VA）方法（使用Middlebrook 7H10琼脂培养基），检测其对链霉素（SM）、异烟肼、利福平和乙胺丁醇（EMB）的敏感性。对结果进行了比较，重点关注三种方法中药物的浓度。在所检测的四种药物中，大部分测量活性的差异见于SM和EMB，这通常是由于三种方法所使用的药物浓度不同所致。发现BACTEC方法中4微克的SM活性略低于VA方法中的10微克，且显著高于WHO方法中4微克的二氢链霉素。对于EMB，BACTEC方法中的2.5微克与VA方法中的5微克以及WHO方法中的2微克相似，而BACTEC方法中的10微克分别比VA方法和WHO方法中的10微克和2微克活性更高。为了达成密切一致，当要与实验室采用的任何传统方法进行比较时，应仔细选择BACTEC方法中使用的药物浓度。非常需要对体外药敏试验进行标准化，以实现用于评估结核病治疗方法的各种检测方法之间的一致性。
