The development of the BSAC standardized method of disc diffusion testing
The development of the BSAC standardized method of disc diffusion testing
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DOI：
10.1093/jac/48.suppl_1.29
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发表时间：
2001-07-01
影响因子：
5.2
通讯作者：
Andrews, JM
中科院分区：
文献类型：
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作者：
Andrews, JM
BSAC 敏感性测试工作组开发了一种标准化的椎间盘敏感性测试方法，该方法已在英国和爱尔兰的 19 个诊断实验室进行了“现场测试”。该方法采用半限定培养基、半汇合接种物，并将抑制区与 BSAC 指定的 MIC 断点相关联，以解释敏感性。选择用于试验的细菌包括来自 ATCC 和 NCTC 国家保藏的临床分离株和对照菌株。选择生物体是因为它们具有已知的属性，例如完全易感或具有已证明的耐药机制。这项调查的结果非常令人鼓舞。对于常见分离的肠杆菌科细菌，特别是大肠杆菌、奇异变形杆菌和克雷伯氏菌，除了庆大霉素和头孢呋辛外，没有观察到重大问题。就庆大霉素而言，问题与奇异变形杆菌的耐药菌株有关，其 MIC 为 2 mg/L，被错误地报告为敏感菌株。对于头孢呋辛，结果不可靠并不意外，因为 MIC 分布跨越体外断点浓度（根据本研究结果，对 MIC 和区域直径断点进行了修改以改进报告）。使用所研究的药剂，铜绿假单胞菌没有遇到重大问题。 “现场调查”表明，纸片测试对于确定凝固酶阴性葡萄球菌对telcoplanin的敏感性并不可靠，并且通过孵育整整24小时可以改善肠球菌中糖肽耐药性的检测。在挑剔的生物体中观察到的不一致与不正确的接种有关。研究的对照菌株的区域直径数据提供了诊断实验室可以用来监测日常测试性能的信息。
The BSAC Working Party on Susceptibility Testing has developed a standardized method of disc susceptibility testing that has been 'field tested' in 19 diagnostic laboratories in the UK and Ireland. The method employs semi-defined media, a semi-confluent inoculum and relates zones of inhibition with BSAC-specified MIC breakpoints to interpret susceptibility. The bacteria selected for the trial included clinical isolates and control strains from the ATCC and NCTC national collections. Organisms were chosen because they had known attributes, such as being fully susceptible or having a demonstrated mechanism of resistance. The results from this survey are very encouraging. With the commonly isolated Enterobacteriaceae, specifically Escherichia coli, Proteus mirabilis and Klebsielia spp., no major problems were observed except with gentamicin and cefuroxime. In the case of gentamicin, problems were associated with resistant strains of P. mirabilis, with MICs of 2 mg/L, being falsely reported as susceptible. For cefuroxime, it is not unexpected that results were unreliable, as the MIC distribution straddles the in vitro breakpoint concentration (following the results of this study the MIC and zone diameter breakpoints have been amended to improve reporting). No major problems were encountered for Pseudomonas aeruginosa with the agents studied. The 'field survey' has shown that disc testing is unreliable for determining the susceptibility of coagulase-negative staphylococci to telcoplanin, and that the detection of glycopeptide resistance in enterococci is improved by incubation for a full 24 h. Inconsistencies observed with fastidious organisms were associated with incorrect inocula. Zone diameter data for the control strains studied provide information that can be utilized by diagnostic laboratories to monitor the daily performance of testing.