Evaluation of the DiversiLab System for Detection of Hospital Outbreaks of Infections by Different Bacterial Species
Evaluation of the DiversiLab System for Detection of Hospital Outbreaks of Infections by Different Bacterial Species
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DOI：
10.1128/jcm.01191-10
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发表时间：
2010-11-01
影响因子：
9.4
通讯作者：
Boel, C. H. E.
中科院分区：
文献类型：
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作者：
Fluit, A. C.;Terlingen, A. M.;Boel, C. H. E.
许多细菌分型方法仅针对一种细菌，耗时，或重复性差。DiversiLab （DL; bioMerieux）有望克服这些限制。在这项研究中，我们评估了DL系统用于识别医院暴发的一些细菌种类。适当分型的临床分离株进行DL检测。不动杆菌（26株）和嗜麦芽寡养单胞菌（13株）的DL分型与脉冲场凝胶电泳（PFGE）一致。除了两个例外，克雷伯菌分离株（n = 23）的DL分型也与PFGE相关，此外，PFGE不可分型（PFGE- nt）分离株也可以分型。肠杆菌（n = 28）的结果也与PFGE结果相关；PFGE-NT分离株可以聚集。在一项更大的研究中（n = 270），观察到一个由30个分离株组成的簇，可以通过PFGE进行细分。大肠杆菌（n = 38）的结果与实验性多位点可变重复序列分析（MLVA）方案的相关性不太好。铜绿假单胞菌（n = 52）对大多数分离株的扩增产物数量有限。当多个假单胞菌分离株在DL中被分配到单一类型时，除了一个外，所有假单胞菌都显示出多个多位点序列类型。耐甲氧西林金黄色葡萄球菌也普遍表现出有限数量的扩增产物。在许多病例中，通过其他分型方法（包括PFGE、spa分型和MLVA）属于不同疫情的分离株被分组在一起。对于粪肠球菌，获得的扩增产物变异性有限，难以解释，且与MLVA和esp基因分型相关性较差。所有的结果都反映在Simpson的多样性指数和调整后的Rand和Wallace系数中。DL是一个有用的工具，可以帮助识别医院爆发的不动杆菌，嗜麦芽链球菌，阴沟肠杆菌，克雷伯氏菌，以及在较小程度上，大肠杆菌。在我们的研究中，DL对铜绿假单胞菌、粪肠杆菌和MRSA是不合适的。然而，应当指出，为了确定疫情，流行病学数据应与分型结果相结合。
Many bacterial typing methods are specific for one species only, time-consuming, or poorly reproducible. DiversiLab (DL; bioMerieux) potentially overcomes these limitations. In this study, we evaluated the DL system for the identification of hospital outbreaks of a number bacterial species. Appropriately typed clinical isolates were tested with DL. DL typing agreed with pulsed-field gel electrophoresis (PFGE) for Acinetobacter (n = 26) and Stenotrophomonas maltophilia (n = 13) isolates. With two exceptions, DL typing of Klebsiella isolates (n = 23) also correlated with PFGE, and in addition, PFGE-nontypeable (PFGE-NT) isolates could be typed. Enterobacter (n = 28) results also correlated with PFGE results; also, PFGE-NT isolates could be clustered. In a larger study (n = 270), a cluster of 30 isolates was observed that could be subdivided by PFGE. The results for Escherichia coli (n = 38) correlated less well with an experimental multilocus variable number of tandem repeats analysis (MLVA) scheme. Pseudomonas aeruginosa (n = 52) showed only a limited number of amplification products for most isolates. When multiple Pseudomonas isolates were assigned to a single type in DL, all except one showed multiple multilocus sequence types. Methicillin-resistant Staphylococcus aureus generally also showed a limited number of amplification products. Isolates that belonged to different outbreaks by other typing methods, including PFGE, spa typing, and MLVA, were grouped together in a number of cases. For Enterococcus faecium, the limited variability of the amplification products obtained made interpretation difficult and correlation with MLVA and esp gene typing was poor. All of the results are reflected in Simpson's index of diversity and adjusted Rand's and Wallace's coefficients. DL is a useful tool to help identify hospital outbreaks of Acinetobacter spp., S. maltophilia, the Enterobacter cloacae complex, Klebsiella spp., and, to a somewhat lesser extent, E. coli. In our study, DL was inadequate for P. aeruginosa, E. faecium, and MRSA. However, it should be noted that for the identification of outbreaks, epidemiological data should be combined with typing results.