用于酵母分离株抗真菌药敏试验的Etest MIC法的多中心可重复性。
Multisite reproducibility of the Etest MIC method for antifungal susceptibility testing of yeast isolates.
作者信息
Pfaller M A, Messer S A, Bolmström A, Odds F C, Rex J H
机构信息
Department of Pathology, University of Iowa College of Medicine, Iowa City 52242, USA.
出版信息
J Clin Microbiol. 1996 Jul;34(7):1691-3. doi: 10.1128/JCM.34.7.1691-1693.1996.
A multicenter study was performed to establish the interlaboratory reproducibility of Etest, to provide an additional comparison of Etest MICs with reference broth macrodilution MICs, and to develop some tentative quality control (QC) guidelines for using Etest for antifungal susceptibility testing of Candida spp. Two QC strains, Candida parapsilosis ATCC 22019 and Candida krusei ATCC 6258, were tested by Etest against amphotericin B, fluconazole, flucytosine, itraconazole, and ketoconazole in each of four laboratories. The QC strains were tested 20 times each against the five antifungal agents by using a common lot of RPMI agar. A total of 80 MICs per drug per strain were generated during the study. Overall, 98 to 100% of the MICs fell within a 3 log2 dilution range for the respective yeast-antifungal agent combinations. The level of agreement of Etest MICs with broth macrodilution MICs was 86 to 100% with amphotericin B (C. krusei and C. parapsilosis), itraconazole (C. krusei and C. parapsilosis), flucytosine (C. parapsilosis), and fluconazole (C. parapsilosis). A lower level of agreement was observed with ketoconazole (C. krusei and C. parapsilosis). Although all participants reported identical Etest MICs, the MICs of flucytosine and fluconazole when tested against C. krusei fell well above the upper limits of the reference range for this strain. The tentative QC limits for the two QC strains and five antifungal agents when tested by the Etest methodology are the same as the QC limits when tested by the reference broth macrodilution method for amphotericin B and C. krusei, itraconazole and C. krusei, flucytosine and C. parapsilosis, fluconazole and C. parapsilosis, and itraconazole and C. parapsilosis. The Etest QC ranges are 1 dilution broader (4-dilution range) than the reference macrodilution method QC ranges for ketoconazole and C. krusei, amphotericin B and C. parapsilosis, and ketoconazole and C. parapsilosis.
开展了一项多中心研究，以确定Etest法在不同实验室间的可重复性，将Etest法测定的最低抑菌浓度（MIC）与参考肉汤稀释法测定的MIC进行额外比较，并制定一些初步的质量控制（QC）指南，用于使用Etest法进行念珠菌属的抗真菌药敏试验。在四个实验室中，利用Etest法对近平滑念珠菌ATCC 22019和克鲁斯念珠菌ATCC 6258这两种QC菌株进行了针对两性霉素B、氟康唑、氟胞嘧啶、伊曲康唑和酮康唑的测试。使用同一批次的RPMI琼脂，对这两种QC菌株针对五种抗真菌药物各进行了20次测试。在该研究期间，每种菌株每种药物共产生了80个MIC。总体而言，对于各自的酵母 - 抗真菌药物组合，98%至100%的MIC落在3个log2稀释范围内。Etest法测定的MIC与肉汤稀释法测定的MIC的一致率在两性霉素B（克鲁斯念珠菌和平滑念珠菌）、伊曲康唑（克鲁斯念珠菌和平滑念珠菌）、氟胞嘧啶（近平滑念珠菌）和氟康唑（近平滑念珠菌）方面为86%至100%。在酮康唑（克鲁斯念珠菌和平滑念珠菌）方面观察到较低的一致率。尽管所有参与者报告的Etest MIC相同，但当针对克鲁斯念珠菌进行测试时，氟胞嘧啶和氟康唑的MIC远高于该菌株参考范围的上限。当通过Etest法进行测试时，两种QC菌株和五种抗真菌药物的初步QC限度与通过参考肉汤稀释法进行测试时针对两性霉素B和克鲁斯念珠菌、伊曲康唑和克鲁斯念珠菌、氟胞嘧啶和近平滑念珠菌、氟康唑和近平滑念珠菌以及伊曲康唑和平滑念珠菌的QC限度相同。Etest法的QC范围比参考稀释法针对酮康唑和克鲁斯念珠菌、两性霉素B和平滑念珠菌以及酮康唑和平滑念珠菌的QC范围宽1个稀释度（4个稀释范围）。
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