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将BD Phoenix和磁盘扩散与汁微稀释进行比较,以确定耐卡巴耐药肠道细菌中塞费皮姆的敏感性

Aliaa Fouad¹, Patricia J Simner², David P Nicolau^1,3

¹Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, Connecticut, USA.

Journal of clinical microbiology

|May 7, 2024

概括

与参考方法相比,对抗卡巴胺耐药肠道细菌 (CRE) 测试cefepime易感性的测试显示BD和磁盘扩散的准确性较低,特别是对于产生卡巴酶的菌株. 这影响了对CRE感染的准确临床决定.

科学领域:

临床微生物学临床微生物学
抗微生物耐药性抗微生物耐药性
传染性疾病传染性疾病

背景情况:

越来越多的报道显示,对卡巴胺耐药的肠道细菌 (CRE) 被测试为易受塞菲皮姆的细菌,这给诊断带来了挑战.
准确的敏感性测试对于指导CRE感染的有效治疗至关重要.

研究的目的:

为了比较BD Phoenix和磁盘扩散 (DD) 与参考微稀释 (BMD) 的cefepime测试性能.
为了评估carbapenemase生产 (CP-KPC-CRE) 和非生产 (非CP CRE) 隔离物的性能.

主要方法:

使用BD Phoenix和磁盘扩散 (DD) 进行了Cefepime敏感性测试.
结果与64个CP-KPC-CRE和58个非CP CRE分离物的参考微稀释 (BMD) 相比.
基本协议 (EA),分类协议 (CA) 和错误率 (ME,VME,MIE) 根据CLSI指南进行计算.

主要成果:

对于CP-KPC-CRE,BD Phoenix显示EA和CA<90%,但对于非CP CRE,EA为96.6%和CA为79.3%.
磁盘扩散 (DD) 对于CP-KPC-CRE和非CP CRE都有<90%的CA.
这两种方法都显示出>10%的轻微错误 (miEs) 和较高的MICs与BMD相比,特别是CP-KPC-CRE.

结论:

在CRE中,BD Phoenix和磁盘扩散在Cefepime敏感性测试中表现不佳,特别是产生卡巴酶的菌株.
观察到的差异,包括轻微的错误和较高的MIC,可能导致易感性错误分类,影响治疗策略.
需要进一步优化自动化系统和磁盘扩散方法,以可靠地检测对CRE的cefepime活性.

关键词:

进入细菌体中的细菌.城是什么意思城是什么意思牛微稀释的方法这是一个很快的时间.磁盘扩散是指光盘的扩散.轻微的错误可能是小的错误.

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