Comparison of the accuracy of disk diffusion zone diameters obtained by manual zone measurements to that by automated zone measurements to determine antimicrobial susceptibility
Comparison of the accuracy of disk diffusion zone diameters obtained by manual zone measurements to that by automated zone measurements to determine antimicrobial susceptibility
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DOI：
10.1016/j.mimet.2008.05.020
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发表时间：
2008-10-01
影响因子：
2.2
通讯作者：
Verbrugh, Henri A.
中科院分区：
文献类型：
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作者：
Lestari, Endang Sri;Severin, Jullette A.;Verbrugh, Henri A.
虽然有多种技术可用于抗菌药物敏感性试验，但纸片扩散法仍然是最广泛使用的方法。我们比较了在低资源国家（印度尼西亚）通过人工区域测量获得的磁盘扩散区直径的准确性，以及在高资源环境（荷兰）通过自动化区域测量（Oxoid光环图像系统）获得的磁盘扩散区直径的准确性，以确定敏感性类别（敏感，中间敏感或抗性）。共分离出683株，其中金黄色葡萄球菌294株，大肠杆菌195株，其他肠杆菌194株。抗菌药物包括：金黄色葡萄球菌用四环素、恶西林、庆大霉素、红霉素、甲氧苄啶/磺胺甲恶唑、氯霉素；大肠杆菌等肠杆菌科用氨苄青霉素、庆大霉素、头孢噻肟、环丙沙星、甲氧苄啶/磺胺甲恶唑、氯霉素。在4098种药物-微生物组合中，两种方法的总体分类一致性（CA）、主要差异（MID）和次要差异（mD）分别为82.4%（3379/4098）、6.0%（244/4098）和11.6%（475/4098）。244个MDs中有163个采用参考肉汤微量稀释法分离。人工区域测量的总体甚大误差（VME）、大误差（ME）和小误差（ME）分别为28.8%、45.4%和4.9%，气场成像系统的总体误差分别为4.9%、16.0%和4.9%。本研究结果表明，在印度尼西亚采用人工区测的圆盘扩散法进行药敏试验是可靠的。使用自动区域读取器，如光环图像系统，将减少错误的数量，从而提高医学相关细菌的药敏试验结果的准确性。(C) 2008 Elsevier B.V.版权所有
Although a variety of techniques are available for antimicrobial susceptibility testing, disk diffusion methods remain the most widely used. We compared the accuracy of disk diffusion zone diameters as obtained by manual zone measurements in a low resource country (Indonesia) to that by automated zone measurements (Oxoid aura image system) in a high resource setting (the Netherlands) to determine susceptibility categories (sensitive, intermediate susceptible or resistant). A total of 683 isolates were studied, including 294 Staphylococcus aureus, 195 Escherichia coli and 194 other Enterobacteriaceae. Antimicrobial agents included tetracycline, oxacillin, gentamicin, erythromycin, trimethoprim/sulfamethoxazole and chloramphenicol for S. aureus and ampicillin, gentamicin, cefotaxime, ciprofloxacin, trimethoprim/sulfamethoxazole, and chloramphenicol for E. coli and other Enterobacteriaceae. Of the 4098 drug-organism combinations, overall category agreement (CA), major discrepancy (MID) and minor discrepancy (mD) between the two methods were 82.4% (3379/4098), 6.0% (244/4098) and 11.6% (475/4098), respectively. One hundred and sixty three of 244 MDs were resolved using reference broth microdilution method. Overall very major error (VME), major error (ME) and minor error (mE) of manual zone measurement were 28.8%, 45.4% and 4.9%, respectively and for the aura image system 4.9%,16.0% and 4.9%, respectively.The results of this study indicate that the disk diffusion method with manual zone measurement in Indonesia is reliable for susceptibility testing. The use of an automated zone reader, such as the aura image system, will reduce the number of errors, and thus improve the accuracy of susceptibility test results for medically relevant bacteria. (C) 2008 Elsevier B.V. All rights reserved.