Jones R N, Johnson D M
Department of Pathology, University of Iowa College of Medicine, Iowa City 52242, USA.
Diagn Microbiol Infect Dis. 1995 Apr;21(4):209-13. doi: 10.1016/0732-8893(94)00061-z.
A collection of ciprofloxacin-resistant organisms (200 strains) was developed among 300 total test strains to "challenge" the initial interpretive criteria developed for clinafloxacin (formerly CI-960), fleroxacin (formerly Ro 23-6240, AM-833), and ciprofloxacin. Generated results indicate the necessity for modified criteria for disk diffusion tests (5-micrograms disks) as follows: for clinafloxacin, susceptible at > or = 21 mm ( < or = 1 microgram/ml) and resistant at < or = 17 mm ( > or = 4 micrograms/ml), or susceptible at > or = 19 mm ( < or = 2 micrograms/liter) and resistant at < or = 15 mm ( > or = 8 micrograms/ml); for fleroxacin, susceptible at > or = 16 mm ( < or = 2 micrograms/ml) and resistant at < or = 11 mm ( > or = 8 micrograms/ml); and for ciprofloxacin, resistant at < or = 17 mm > or = 4 micrograms/ml). These modifications maximize total absolute interpretive accuracy between the standardized test methods, especially minimizing the potential for false susceptibility (very major errors) when testing truly resistant isolates. The clinafloxacin spectrum was widest against these resistant isolates, and the other two tested fluoroquinolones (ciprofloxacin, fleroxacin) possessed comparable overall spectrums of activity, although ciprofloxacin was generally more active on a weight basis. We urge the rapid acceptance of these criteria to improve the accuracy of the widely used National Committee for Clinical Laboratory Standards method for disk diffusion tests.
在300株受试菌株中培养出一组耐环丙沙星的菌株（200株），以“检验”为克林沙星（原CI-960）、氟罗沙星（原Ro 23-6240，AM-833）和环丙沙星制定的初始解释标准。所得结果表明，需对纸片扩散试验（5微克纸片）的标准进行如下修改：对于克林沙星，抑菌圈直径≥21毫米（≤1微克/毫升）为敏感，≤17毫米（≥4微克/毫升）为耐药；或抑菌圈直径≥19毫米（≤2微克/升）为敏感，≤15毫米（≥8微克/毫升）为耐药；对于氟罗沙星，抑菌圈直径≥16毫米（≤2微克/毫升）为敏感，≤11毫米（≥8微克/毫升）为耐药；对于环丙沙星，抑菌圈直径≤17毫米（≥4微克/毫升）为耐药。这些修改使标准化试验方法之间的总绝对解释准确性最大化，尤其是在检测真正耐药菌株时，将假敏感（极重大错误）的可能性降至最低。克林沙星对这些耐药菌株的抗菌谱最广，另外两种受试氟喹诺酮类药物（环丙沙星、氟罗沙星）的总体抗菌谱相当，尽管以重量计环丙沙星通常活性更强。我们敦促尽快采用这些标准，以提高广泛使用的美国国家临床实验室标准委员会纸片扩散试验方法的准确性。
