K-B法和VITEK2法检测108株大肠埃希氏菌18种抗生素耐药表型的一致性研究

Consistency of 18 kinds of antibiotic resistance phenotypes in 108 strains of Escherichia coli measured by K-B and VITEK2 methods

中文关键词:  大肠埃希氏菌  耐药表型  K-B法  VITEK2法

英文关键词:Escherichia coli  antibiotic resistance phenotype  K-B method  VITEK2 method

中文摘要:

      目的 运用K-B法和VITEK2法检测大肠埃希氏菌对氨苄西林等18种抗生素的药敏情况, 对比研究二者结果的一致性。方法 收集食源性大肠埃希氏菌108株(32株产β-内酰胺酶的大肠埃希氏菌Escherichia coli producing β-lactamase, ESBLs+E. coli; 76株不产β-内酰胺酶的大肠埃希氏菌Escherichia coli non-producing β-lactamase, ESBLs-E. coli), 通过K-B法和VITEK2法检测大肠埃希氏菌对18种抗生素的敏感性。结果 除了复方新诺明, 两种方法检测其他17种抗生素的敏感率、中介率和耐药率均无统计学上的差异; 18种抗生素的一致率(catagorical agreement, CA)在85.18%~100.00%之间, 非常重大误差(very major error, VME)在0%~26.41%之间, 重大误差(major error, ME)在0%~1.78%之间, 次要误差(minor error, MIE)在0%~12.04%之间。其中氨苄西林/舒巴坦的CA (87.96%)、复方新诺明的CA (85.18%)、氨曲南的VME (7.14%)、复方新诺明的VME (26.41%)和氨苄西林/舒巴坦的MIE (12.04%)不符合标准要求。结论 K-B法与VITEK2法在耐药表型测定方面不具有完全等同性, K-B法对异质性耐药菌识别能力优于VITEK2法, 但是在检测复方新诺明耐药表型时, 可采用其他方法进行验证, 综合判断后确定结果。

英文摘要:

      Objective To detect the drug sensitivity of Escherichia coli to 18 kinds of antibiotics such as ampicillin by K-B method and VITEK2 method, and the compare and study the consistency of the two results. Methods The 108 strains of food-borne Escherichia coli (32 strains of Escherichia coli producing β-lactamase, ESBLs+E. coli; 76 strains of Escherichia coli non-producing β-lactamase, ESBLs-E. coli) were used to detect the sensitivity of Escherichia coli to 18 kinds of antibiotics by K-B method and VITEK2 method. Results Except for co-trimoxazole, there was no statistical difference in sensitivity, intermediary rate and drug resistance between the two methods for detecting other 17 kinds of antibiotics. The catagorical agreement (CA) of 18 kinds of antibiotics was between 85.18% and 100.00%, the very major error (VME) was between 0% and 26.41%, the major error (ME) was between 0% and 1.78%, and the minor error (MIE) was between 0% and 12.04%. Among them, CA of ampicillin/sulbactam (87.96%), CA of co-trimoxazole (85.18%), VME of aztreonam (7.14%), VME of co-trimoxazole (26.41%) and MIE of ampicillin/sulbactam (12.04%) did not meet the standard requirements. Conclusion K-B method and VITEK2 method are not completely equivalent in the determination of drug resistance phenotype, and K-B method is superior to VITEK2 method in identifying heterogeneous drug-resistant bacteria, but other methods can be used to verify the drug resistance phenotype of co-trimoxazole, and the results can be determined after comprehensive judgment.