RAPID ANTIMICROBIAL SUSCEPTIBILITY TESTING OF ISOLATES FROM BLOOD CULTURES BY DIRECT INOCULATION AND EARLY READING OF DISK DIFFUSION TESTS
RAPID ANTIMICROBIAL SUSCEPTIBILITY TESTING OF ISOLATES FROM BLOOD CULTURES BY DIRECT INOCULATION AND EARLY READING OF DISK DIFFUSION TESTS
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DOI：
10.1128/jcm.20.3.473-477.1984
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发表时间：
1984-01-01
影响因子：
9.4
通讯作者：
SCHOENKNECHT, FD
中科院分区：
文献类型：
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作者：
COYLE, MB;MCGONAGLE, LA;SCHOENKNECHT, FD
直接从阳性患者血培养中接种的纸片扩散试验，评估了在4小时和6小时以及隔夜孵育后读取区域直径的准确性。与标准纸片扩散法结果比较，革兰氏阳性菌的4h结果符合率为83%，革兰氏阴性菌的符合率为%。忽略微小差异后，98%的革兰氏阳性菌和95%的革兰氏阴性菌的4小时读数是一致的。培养6h后，91%的革兰氏阳性菌和86%的革兰氏阴性菌的检测结果与标准结果一致。排除微小差异后，革兰氏阳性和革兰氏阴性细菌检测的符合率为99%。在革兰氏阳性菌的2项检测中出现了非常大的差异(0.1%)，而在革兰氏阴性菌的检测中没有观察到。4h、6h和过夜孵化的主要差异频率分别为3.5%、0.6%和0.7%。对大肠埃希菌和克雷伯氏菌进行氨苄西林和头孢菌素试验。占革兰氏阴性菌检测主要差异的81%。苯唑西林测试占葡萄球菌测试中主要差异的一半以上。这项不包括较新抗生素的研究结果表明，培养6小时后读取的血培养直接药敏试验比4小时结果更可靠，与标准药敏试验相比，产生1%的主要误差。
Disc diffusion tests, inoculated directly from positive patient blood cultures, were evaluated for accuracy of reading zone diameters after 4- and 6-h and overnight incubation. In comparisons with results from standard disc diffusion tests, the 4-h results were in agreement for 83% of tests with gram-positive organisms and 64% of tests with gram-negative organisms. When minor discrepancies were ignored, the 4-h readings were in agreement for 98% of the tests with gram-positive organisms and 95% of the tests with gram-negative organisms. After 6 h of incubation, 91% of the tests with gram-positive organisms and 86% of the tests with gram-negative organisms agreed with standard results. The agreement was 99% for tests with both gram-positive and gram-negative organisms when minor discrepancies were excluded. Very major discrepancies occurred in 2 tests (0.1%) with gram-positive organisms and were not observed in tests with gram-negative organisms. The frequencies of major discrepancies were 3.5% after 4 h, 0.6% after 6 h and 0.7% after overnight incubation. Ampicillin and cephalothin tests with Escherichia coli and Klebsiella spp. accounted for 81% of the major discrepancies in tests with gram-negative organisms. Oxacillin tests accounted for more than half of the major discrepancies in tests with staphylococci. The results of this study, which did not include the newer antibiotics, indicate that direct susceptibility tests from blood cultures read after 6 h of incubation are more reliable than 4-h results and produce < 1% major errors in comparisons with standard susceptibility tests.