Marley E F, Mohla C, Campos J M
Department of Pathology, George Washington University Medical Center, Washington, DC 20037, USA.
J Clin Microbiol. 1995 Dec;33(12):3191-3. doi: 10.1128/jcm.33.12.3191-3193.1995.
We determined the E-Test and National Committee for Clinical Laboratory Standards standardized agar dilution MICs of ceftazidime, ciprofloxacin, piperacillin, and tobramycin for Pseudomonas aeruginosa during tests of 100 rough and mucoid P. aeruginosa isolates from cystic fibrosis patients. The levels of agreement (+/- 1 log2 dilution) between quantitative E-Test and agar dilution MIC results were 80, 97, 73, and 89% for ceftazidime, ciprofloxacin, piperacillin, and tobramycin, respectively. Comparison of the results after converting the MIC data to qualitative categories (susceptible, intermediate, and resistant) yielded levels of agreement of 84, 96, 88, and 93% for the same agents, respectively. Of the 39 qualitative discrepancies, 36 were minor and 3 were very major. We conclude that use of the E-Test is easier and more practical than use of the agar dilution method for most laboratories and that the E-Test furnishes results which are at least as accurate as those obtained by the agar dilution method. However, the higher cost of the E-Test method would likely discourage most laboratories from selecting it over disk diffusion for routine antimicrobial susceptibility testing of P. aeruginosa isolates from cystic fibrosis patients.
在对100株来自囊性纤维化患者的粗糙型和黏液型铜绿假单胞菌分离株进行检测时，我们测定了头孢他啶、环丙沙星、哌拉西林和妥布霉素对铜绿假单胞菌的E试验及美国国家临床实验室标准委员会标准化琼脂稀释法的最低抑菌浓度（MIC）。头孢他啶、环丙沙星、哌拉西林和妥布霉素定量E试验与琼脂稀释法MIC结果之间的一致性水平（±1个log2稀释度）分别为80%、97%、73%和89%。将MIC数据转换为定性类别（敏感、中介和耐药）后进行结果比较，相同药物的一致性水平分别为84%、96%、88%和93%。在39个定性差异中，36个为微小差异，3个为极显著差异。我们得出结论，对于大多数实验室而言，使用E试验比使用琼脂稀释法更简便、更实用，且E试验提供的结果至少与琼脂稀释法获得的结果一样准确。然而，E试验方法较高的成本可能会使大多数实验室在对囊性纤维化患者的铜绿假单胞菌分离株进行常规抗菌药物敏感性检测时，不会选择它而放弃纸片扩散法。
