Akilli Fatih M, Ilki Doga, Ulger-Toprak Nurver, Ilki Arzu
Clin Lab. 2025 Aug 1;71(8). doi: 10.7754/Clin.Lab.2024.241232.
Rapid, simple, and accurate methods are needed to detect colistin susceptibility in multidrug-resistant Gram-negative isolates. Both EUCAST and CLSI recommend broth microdilution (BMD) for antimicrobial susceptibility testing of colistin, but BMD is rarely used in routine microbiology laboratories. In search of alternative, more practical methods, some commercial kits were propagated, along with CLSI's recommendation of using Colistin disc elution method. In this study, we aimed to compare colistin susceptibility testing both by MMS, which is a commercial BMD product, and by Colistin disc elution method to BMD using multidrug-resistant Acinetobacter baumanii, Pseudomonas aeruginosa, and Klebsiella pneumoniae.
Multidrug-resistant Acinetobacter baumannii, P. aeruginosa, and K. pneumoniae isolates detected from various clinical samples in Marmara University Pendik Training and Research Hospital´s clinical microbiology laboratory between January 1, 2021, and July 30, 2022, were included in the study. Colistin susceptibilities were determined using the CBDE method, Micronaut MIC Strip colistin assay (MMS), and BMD. The results were compared with BMD as the reference method. Categorical agreement (CA), essential agreement (EA), major error (ME), and very major error (VME) rates were calculated.
The study included 185 multidrug-resistant A. baumannii, P. aeruginosa, and K. pneumoniae isolates from various clinical samples. Out of these isolates, 13 (6.5%) were found to be resistant. The MMS test demonstrated a categorical agreement (CA) of 100% for A. baumannii and P. aeruginosa, while the CBDE method achieved a CA of 100% only with A. baumannii.
Both the MMS and CBDE tests are compatible with the BMD method. The CBDE, which does not require specialized equipment or advanced techniques, may be more suitable for laboratories with limited resources. In contrast, laboratories with greater financial means may find the MMS test to be advantageous in providing an accurate minimum inhibitory concentration.
需要快速、简单且准确的方法来检测多重耐药革兰氏阴性菌分离株对黏菌素的敏感性。欧洲抗菌药物敏感性试验委员会（EUCAST）和美国临床和实验室标准协会（CLSI）均推荐使用肉汤微量稀释法（BMD）进行黏菌素的抗菌药物敏感性试验，但BMD在常规微生物实验室中很少使用。为了寻找替代的、更实用的方法，一些商业试剂盒得到了推广，同时CLSI推荐使用黏菌素纸片洗脱法。在本研究中，我们旨在比较使用商业BMD产品MMS和黏菌素纸片洗脱法对多重耐药鲍曼不动杆菌、铜绿假单胞菌和肺炎克雷伯菌进行黏菌素敏感性试验与BMD的结果。
纳入2021年1月1日至2022年7月30日在马尔马拉大学彭迪克培训与研究医院临床微生物实验室从各种临床样本中检测到的多重耐药鲍曼不动杆菌、铜绿假单胞菌和肺炎克雷伯菌分离株。使用纸片洗脱法（CBDE）、Micronaut MIC药敏试纸条黏菌素检测法（MMS）和BMD测定黏菌素敏感性。将结果与作为参考方法的BMD进行比较。计算分类一致性（CA）、基本一致性（EA）、主要误差（ME）和非常主要误差（VME）率。
该研究纳入了来自各种临床样本的185株多重耐药鲍曼不动杆菌、铜绿假单胞菌和肺炎克雷伯菌分离株。在这些分离株中，发现13株（6.5%）耐药。MMS试验对鲍曼不动杆菌和铜绿假单胞菌的分类一致性（CA）为100%，而CBDE方法仅对鲍曼不动杆菌的CA达到100%。
MMS和CBDE试验均与BMD方法兼容。CBDE不需要专门设备或先进技术，可能更适合资源有限的实验室。相比之下，资金更充裕的实验室可能会发现MMS试验在提供准确的最低抑菌浓度方面具有优势。
