Susceptibility of enterococci to daptomycin is dependent upon testing methodology
Susceptibility of enterococci to daptomycin is dependent upon testing methodology
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DOI：
10.1016/j.diagmicrobio.2013.04.019
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发表时间：
2013-08-01
影响因子：
2.9
通讯作者：
Van Schooneveld, Trevor C.
中科院分区：
文献类型：
--
作者：
Bryant, Kendall A.;Roberts, Amity L.;Van Schooneveld, Trevor C.
使用MicroScan方法发现，我们机构中的达托霉素不敏感肠球菌（DNSE）增加（2008年为8.3%，2011年为34.5%），这可能高估了DNSE患病率。使用肉汤微量稀释法（BMD）、Etest、Sensititire、MicroScan prompt（MSP）和MicroScan浊度法（MST）对来自临床实验室（2008-2011年）的DNSE（N = 150）进行了药敏试验，仅20%的分离株确认为不敏感。MSP和MST的分类和基本一致性最高，但两者均遗漏了大多数耐药菌株（70%和87%遗漏）。Etest MIC值在统计学上更高，更可能不敏感，具有最低的非常重大错误率（37%）和最高的假不敏感率（22%）。灵敏度MIC值与BMD无统计学差异，但遗漏了57%的DNSE。PFGE分析并未定义克隆爆发。这些发现表明，MicroScan方法高估了非敏感性，并且方法之间缺乏相关性，这引发了关于哪种方法在确认非敏感性方面最有效的问题。(c)2013 Elsevier Inc. All rights reserved.
An increase in daptomycin nonsusceptible enterococci (DNSE) was noted in our institution (8.3% 2008 to 34.5% 2011) using MicroScan methods which may overestimate DNSE prevalence. DNSE (N = 150) from the clinical laboratory (2008-2011) underwent susceptibility testing using broth microdilution (BMD), Etest, Sensititire, MicroScan prompt (MSP), and MicroScan turbidity (MST) with only 20% of isolates confirmed as nonsusceptible. Categorical and essential agreement were highest with MSP and MST, but both missed the majority of resistant isolates (70% and 87% missed). Etest MIC values were statistically higher, more likely to be nonsusceptible, had the lowest very major error rate (37%), and the highest falsely nonsusceptible rate (22%). Sensititre MIC values were not statistically different from BMD, but missed 57% of DNSE. PFGE analysis did not define a clonal outbreak. These findings suggest that MicroScan methods overestimate nonsusceptibility, and the lack of correlation between methods raises questions regarding which method is most effective at confirming nonsusceptibility. (c) 2013 Elsevier Inc. All rights reserved.