摘要
目的调查全国细菌耐药监测网中使用VITEK-2药敏检测系统的医院微生物实验室药敏检测结果的准确性。方法向参加调研的425所医院的微生物实验室同时发放两株编号分别为Carss-14-QC001(产ESBLs大肠埃希菌)和Carss-14-QC002(产KPC肺炎克雷伯菌)的质控测试菌株,以微量肉汤稀释法作为参考方法,通过计算各实验室药敏结果基本一致性(EA)、分类一致性(CA)、非常重大误差(VME)、重大误差(ME)和小误差(mE)分析评估参评实验室药敏结果测定的准确性。结果Carss-14-QC001的药敏测试结果:氨苄西林/舒巴坦和头孢曲松的EA(24.7%、51.6%)和CA(21.9%、79.2%)较低,其他抗菌药物的EA和CA值均〉90.0%;氨苄西林、氨苄西林/舒巴坦、头孢曲松、头孢替坦和磺胺甲噁唑/甲氧苄啶各出现一个VME结果;仅一个参评实验室(0.3%)的ESBL检测结果错误;Carss-14-QC002药敏结果:头孢替坦的EA(24.6%)和CA(21.2%)最低,美罗培南和头孢吡肟的EA(81.0%和82.1%)和CA(41.0%和76.9%)较低,其他抗菌药物的EA和CA均〉90.0%;美罗培南VME百分率为6.2%,其余抗菌药物VME百分率较低为0~1.2%;抗菌药物对二株测试菌株药敏结果的ME均较低为0~0.7%。结论全国VITEK-2细菌药敏检测系统中氨苄西林/舒巴坦、头孢曲松、头孢替坦、美罗培南和头孢吡肟的药敏检测结果一致性和准确性较低,其他抗菌药物的药敏结果均具有很好的一致性和较高的准确性。
OBJECTIVE To evaluate the accuracies of the VITEK-2automated susceptibility test systems used in China Antimicrobial Resistance Surveillance System hospitals.METHODS Two isolates named Carss-14-QC001(ESBL-producing E.coli)and Carss-14-QC002(KPC-producing Klebsiella pneumoniae)were sent to 425 hospitals in China at the same time.By means of broth microdilution method,the essential agreement(EA),categorical agreement(CA),very major error(VME),major error(ME)and minor error(mE)were calculated to evaluate the accuracies of the antimicrobial susceptibility test results reported from the hospitals.RESULTS The antimicrobial susceptibility testing results of the Carss-14-QC001 isolate showed that the EA(24.7%,51.6%)and CA(21.9%,79.2%)of ampicillin-sulbactam and ceftriaxone were relatively low,and the EA and CA of other antibiotics were more than 90.0%;each one single VME result was shown for ampicillin,ampicillin-sulbactam,ceftriaxone,cefotetan,and trimethoprim-sulfamethoxazole;there was only one(0.3%)error ESBL result.The antimicrobial susceptibility testing results of the Carss-14-QC002 isolate indicated that the EA(24.6%)and CA(21.2%)of cefotetan were the the lowest,the EA(81.0%and 82.1%)and CA(41.0%and 76.9%)of meropenem and cefepime were relatively low,and the EA and CA of other antibiotics were more than 90.0%;the VME of meropenem was 6.2%,and the VME of other antibiotics varied from 0to 1.2%.The drug susceptibility testing results of the two test isolates showed that the ME of the antibiotics varied from 0to 0.7%.CONCLUSION The consistencies and accuracies of the antimicrobial susceptibility testing results of ampicillin-sulbactam,ceftriaxone,cefotetan,meropenem,and cefepime are relatively low with the use of VITEK-2automated susceptibility test systems,while the consistencies and accuracies of the antimicrobial susceptibility testing results of other antibiotics are relatively high.
作者
孙宏莉
胡继红
罗燕萍
杨启文
徐英春
SUN Hong-li;HU Ji-hong;LUO Yan-ping;YANG Qi-wen;XU Ying-chun(Chinese Academy of Medical Sciences,Peking Union Medical College Hospital,Beijing 100730,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第10期2161-2165,共5页
Chinese Journal of Nosocomiology
基金
国家科技重大专项基金资助项目(2014ZX09507009-028)
关键词
VITEK-2
药敏试验
抗菌药物
质量控制
VITEK-2
Antimicrobial susceptibility testing
Antibacterial agent
Quality control
作者简介
通信作者:徐英春,E-mail:xycpumch@139.com
