Fraser S L, Jorgensen J H
Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas 78234-6200, USA.
Antimicrob Agents Chemother. 1997 Dec;41(12):2738-41. doi: 10.1128/AAC.41.12.2738.
Several Flavobacterium species, comprising a heterogeneous group of gram-negative bacilli that are capable of causing opportunistic infections in humans, have recently been reclassified as Chryseobacterium or Myroides species. Intrinsically resistant to a number of antibiotics, these organisms have been reported to be susceptible to vancomycin and certain other drugs that are normally active against gram-positive bacteria. By using the National Committee for Clinical Laboratory Standards (NCCLS) broth microdilution procedure, 58 clinical isolates of former flavobacteria (36 Chryseobacterium meningosepticum isolates, 11 C. indologenes isolates, 3 C. gleum isolates, 4 unspeciated former members of Flavobacterium group IIb, and 4 Myroides odoratum isolates) were tested with 23 antibiotics, including conventional and investigational agents. In addition, the broth microdilution results were compared to those generated by agar dilution, E-test, and disk diffusion for vancomycin and piperacillin-tazobactam. Compared to the NCCLS microdilution results, there were 7.1 and 17.9% very major errors with piperacillin-tazobactam by agar dilution and E-test, respectively. In addition, there were from 12.1 to 48.3% minor errors with both procedures with vancomycin and piperacillin-tazobactam. The very major and minor error rates were unacceptably high with disk testing of piperacillin-tazobactam; the use of enterococcal vancomycin disk breakpoints (zone diameter of > or =17 mm = susceptible) resulted in >20% minor errors but only one very major error. All of the isolates were susceptible to minocycline; over 90% were susceptible to sparfloxacin, levofloxacin, and clinafloxacin; and 88% were susceptible to rifampin. None was susceptible to vancomycin. When Chryseobacterium or Myroides species are isolated from serious infections, susceptibility testing by broth microdilution should be performed and therapy should be guided by those results.
几种黄杆菌属细菌，它们是一组革兰氏阴性杆菌，能够在人类中引起机会性感染，最近已被重新分类为金黄杆菌属或嗜木杆菌属细菌。这些微生物对多种抗生素具有固有抗性，但据报道它们对万古霉素和某些通常对革兰氏阳性菌有效的其他药物敏感。通过使用美国国家临床实验室标准委员会（NCCLS）的肉汤微量稀释法，对58株先前的黄杆菌临床分离株（36株脑膜炎败血金黄杆菌分离株、11株吲哚金黄杆菌分离株、3株黏金黄杆菌分离株、4株未分类的黄杆菌属IIb组前成员以及4株恶臭嗜木杆菌分离株）进行了23种抗生素的测试，包括传统药物和研究用药物。此外，将肉汤微量稀释结果与万古霉素和哌拉西林 - 他唑巴坦的琼脂稀释法、E试验法和纸片扩散法的结果进行了比较。与NCCLS微量稀释结果相比，琼脂稀释法和E试验法检测哌拉西林 - 他唑巴坦时分别有7.1%和17.9%的极重大误差。此外，万古霉素和哌拉西林 - 他唑巴坦的两种方法都有12.1%至48.3%的微小误差。哌拉西林 - 他唑巴坦纸片试验的极重大和微小误差率高得令人无法接受；使用肠球菌万古霉素纸片折点（抑菌圈直径≥17 mm为敏感）导致微小误差>20%，但只有一个极重大误差。所有分离株对米诺环素敏感；超过90%对司帕沙星、左氧氟沙星和克林沙星敏感；88%对利福平敏感。无一株对万古霉素敏感。当从严重感染中分离出金黄杆菌属或嗜木杆菌属细菌时，应通过肉汤微量稀释法进行药敏试验，并根据这些结果指导治疗。
