O'Hara C M, Tenover F C, Miller J M
Nosocomial Pathogens Laboratory Branch, Centers for Disease Control and Prevention (C16), Atlanta, Georgia 30333.
J Clin Microbiol. 1993 Dec;31(12):3165-9. doi: 10.1128/jcm.31.12.3165-3169.1993.
We compared the API 20E (21 h) (API; bioMérieux Vitek, Hazelwood, Mo.), the Vitek GNI card (4 to 18 h) (Vitek; bioMérieux Vitek), the identification portion of the MicroScan Walk/Away Rapid Neg Combo 3 panel (2 h) (W/A; Baxter Diagnostics, Inc., West Sacramento, Calif.), and the Becton Dickinson Cobas Micro ID-E/NF rotor (21 h) (Cobas; Becton Dickinson Diagnostic Instrument Systems, Sparks, Md.), versus conventional biochemicals for their abilities to identify accurately 252 strains of biochemically typical and atypical members of the family Enterobacteriaceae and common non-glucose-fermenting gram-negative bacilli. All strains used were included in the data base of each product. At the end of the initial incubation, 194 (77.0%), 213 (84.5%), 198 (78.6%), and 192 (76.2%) strains were correct to the genus and species levels with the API, Vitek, W/A, and Cobas systems, respectively. After additional biochemical tests were performed, as directed by each manufacturer's protocol, the numbers of strains correctly identified to the genus and species levels were 241 (95.6%), 234 (92.8%), 243 (96.4%), and 230 (91.3%) with the four systems, respectively. The errors were random in all systems, with the exception of two atypical Salmonella enteritidis strains, each of which was misidentified by three systems. After the initial recommended incubation period, both API and Cobas were significantly less accurate than Vitek (Yates' corrected P < 0.05). No significant differences were noted between the results of Vitek and W/A or between the results of API and W/A. After additional tests were completed, Cobas was significantly less accurate than W/A (P < 0.05) but was equal in accuracy to Vitek and API. API, Vitek, and W/A were equal in accuracy after these same additional tests. All four systems were significantly more accurate after additional biochemical testing than after the initial reporting period (194 of 252 versus 241 of 252 for API, 213 of 252 versus 234 of 252 for Vitek, 198 of 252 versus 243 or 252 for W/A, and 192 of 252 versus 230 of 252 for Cobas [P<0.05]).
我们将API 20E（21小时）（API；法国生物梅里埃公司，密苏里州黑兹尔伍德）、Vitek GNI卡（4至18小时）（Vitek；法国生物梅里埃公司）、MicroScan Walk/Away快速阴性组合3板的鉴定部分（2小时）（W/A；美国百特诊断公司，加利福尼亚州西萨克拉门托）以及贝克曼库尔特Cobas Micro ID-E/NF转子（21小时）（Cobas；美国贝克曼库尔特诊断仪器系统公司，马里兰州斯帕克斯）与传统生化方法进行比较，以评估它们准确鉴定252株生化典型和非典型肠杆菌科成员及常见非发酵葡萄糖革兰氏阴性杆菌的能力。所有使用的菌株均包含在各产品的数据库中。在初次培养结束时，使用API、Vitek、W/A和Cobas系统分别有194株（77.0%）、213株（84.5%）、198株（78.6%）和192株（76.2%）菌株在属和种水平上鉴定正确。按照各制造商的方案进行额外生化试验后，这四种系统在属和种水平上正确鉴定的菌株数分别为241株（95.6%）、234株（92.8%）、243株（96.4%）和230株（91.3%）。除了两株非典型肠炎沙门氏菌菌株外，所有系统中的错误都是随机的，这两株菌均被三种系统误鉴定。在初次推荐培养期结束后，API和Cobas的准确性均显著低于Vitek（耶茨校正P<0.05）。Vitek和W/A的结果之间以及API和W/A的结果之间未观察到显著差异。在完成额外试验后，Cobas的准确性显著低于W/A（P<0.05），但与Vitek和API的准确性相当。经过这些相同的额外试验后，API、Vitek和W/A的准确性相当。所有四种系统在进行额外生化试验后的准确性均显著高于初次报告期（API：252株中194株对252株中241株；Vitek：252株中213株对252株中234株；W/A：252株中198株对252株中243株；Cobas：252株中192株对252株中230株[P<0.05]）。
