«上一篇/Previous Article|本期目录/Table of Contents|下一篇/Next Article»

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

21卷

期数:

2015年06期

页码:

510-513

栏目:

临床医学

出版日期:

2015-11-20

文章信息/Info

Title:

Effect of Tigecycline on Klebsiella pneumoniae and Acinetobacter baumanaii by susecptibility testing in vitro

文章编号:

1006-8147（2015）06-0510-04

作者:

余 倩; 胡志东; 李 静; 李妍淳; 李 金

(天津医科大学总医院医学检验科,天津 300052)

Author(s):

YU Qian; HU Zhi-dong; LI Jing; LI Yan-chun; LI Jin

?

(Department of Laboratory Medicine, ?General Hospital,Tianjin Medical University ,Tianjin 300052,China)

关键词:

替加环素; 肺炎克雷伯菌; 鲍曼不动杆菌; 微生物敏感性实验; 体外

Keywords:

tigecycline' target="_blank" rel="external">">tigecycline; Klebsiella pneumoniae; Acinetobacter baumanaii; microbial sensitivity tests; in vitro

分类号:

R446.5

DOI:

-

文献标志码:

A

摘要:

目的：比较3种药敏方法在判定菌株对替加环素不敏感结果的一致性。方法：收集Vitek 2 Compact系统测定的对替加环素不敏感菌株110株，其中肺炎克雷伯菌59株，鲍曼不动杆菌51株，纸片扩散法及MIC Test Strip( MTS)法进行复核检测对替加环素的敏感性。结果：以MTS法为参考方法，Vitek 2法检测菌株与MTS法的一致率，MTS法采用EUCAST折点优于FDA折点，并且误差率较FDA折点低。VITEK2法检测肺炎克雷伯菌对替加环素敏感性与MTS法的一致率高于纸片法，而检测鲍曼不动杆菌的一致率低于纸片法。产ESBL肺炎克雷伯菌对替加环素的耐药率高于非产ESBL肺炎克雷伯菌，Vitek 2 MIC₅₀较MTS MIC₅₀高一个稀释度。CRAB对替加环素的敏感率为100%（MTS法/FDA折点），CSAB的中介率为77.8%，未发现耐药株。结论：Vitek 2法与纸片法均不能作为检测肺炎克雷伯菌与鲍曼不动杆菌对替加环素敏感性的常规方法，应采用MTS法或肉汤稀释法对不敏感菌株进行复核。

Abstract:

?Objective: To compare Klebsiella pneumoniae and Acinetobacter baumanaii in vitro susceptibility to tigecycline by three different susceptibility testing methods . Methods: Fifty nine isolates of Klebsiella pneumoniae and 51 isolates of Acinetobacter baumanaii,nonsusceptibility to tigecycline by Vitek 2 of which were collected from February 2014 to January 2015 ,and then were confirmed by disk diffusion method and MIC Test Strip(MTS). Results: Compared with MTS method which was on the basis of EUCAST interpretive criteria, the CA of Vitek 2 was higher than FDA for Klebsiella pneumoniae and Acinetobacter baumanaii, and the error was lower. Vitek 2 produced higher CA result for Klebsiella pneumoniae than disk diffusion, but the CA result for Acinetobacter baumanaii was the opposite. The resistance rate of ESBL-producing K. pneumoniae isolates was higher than non-ESBL- producing K. pneumoniae, and Vitek 2 result in MIC₅₀ in 1 dilution was higher compared with MTS. Remarkably high tigecycline susceptibility rates (100%) were found among the Carbapenem-resistant A. baumanaii by MTS method, the intermediate rate of Carbapenem-susceptible A. baumanaii to tigecycline was 77.8%,and no resistant strains to tigecycline was found. Conclusion: For routine susceptibility testing of K. pneumoniae and A. baumannii on tigecycline, the disk method and Vitek2 may not be proper because of the poor correlation of results between the MTS .

参考文献/References:

[1]张冀霞，赵春江，刘文云，等. 替加环素对鲍曼不动杆菌和肺炎克雷伯菌体外抗菌活性检测的影响因素和方法学评估[J].中华检验医学杂志,2013,36(7):604
[2] Clinical and Laboratory Standards Institute．M23-A3 Development of in vitro susceptibility testing criteria and quality control
parameters：approved guidelineWayne, PA：CLI, 2008
[3]Navon-Venezia S, Leavitt A, Carmeli Y. High tigecycline resistance in
multidrug-resistant Acinetobacter baumannii[J].J Antimicrob
Chemother, 2007,59(4):772
[4]Pillar C M, Draghi D C, Dowzicky M J, et al. In vitro activity of tigecycline against gram-positive and gram-negative pathogens as evaluated by broth microdilution and E test [J].J Clin Microbiol,2008,46(9):2862
[5]杜小幸，王海萍，傅鹰，等. 不同药敏方法检测替加环素对鲍曼不动杆菌敏感性的比较[J].中华检验医学杂志,2013,36(7):598
[6]王辉，俞云松，王明贵，等. 替加环素体外药敏试验操作规程专家共识[J].中华检验医学杂志,2013,36(7):584
[7]何翠娥，李妍淳，田彬，等. 鲍曼不动杆菌和肺炎克雷伯菌对替加环素体外敏感性检测的方法学评估[J].中华临床感染病杂志,2013,6(5):28[8]Zarkotou O, Pournaras S, Altouvas G, et al. Comparative evaluation of tigecycline susceptibility testing methods for expanded-spectrum cephalosporin- and carbapenem-resistant gram-negative , pathogens[J]. J Clin Microbiol，2012,50(11):3747
[9]Liu J W, Ko W C, Huang C H, et al. Agreement assessment of tigecycline susceptibilities determined by the disk diffusion and broth microdilution methods among commonly encountered resistant bacterial isolates: results from the Tigecycline In Vitro Surveillance in Taiwan (TIST) study, 2008 to 2010[J].Antimicrob Agents Chemother, 2012,56(3):1414
[10]Huang T D, Berhin C, Bogaerts P, et al.In vitro susceptibility of multidrug-resistant Enterobacteriaceae clinical isolates to tigecycline[J].J Antimicrob Chemother, 2012,67(11):2696
[11]Sader H S, Flamm R K, Jones R N. Tigecycline activity tested against antimicrobial resistant surveillance subsets of clinical bacteria collected worldwide (2011)[J].Diagn Microbiol Infect Dis, 2013,76(2):217
?

相似文献/References:

[1]张德林,李忠廉,张西波. 替加环素与碳青霉烯类抗生素治疗多重耐药鲍曼不动杆菌感染疗效比较[J].天津医科大学学报,2015,21(02):164.
　ZHANG De-lin[],LI Zhong-lian,ZHANG Xi-bo. Comparsion of clinical effects between tigecycline and carbapenems in treatment of infections caused by multidrugresistant Acinetobacter baumannii[J].Journal of Tianjin Medical University,2015,21(06):164.
[2]唐洪影,李 静,宋缘缘,等.耐碳青霉烯类肺炎克雷伯菌感染及预后相关因素分析[J].天津医科大学学报,2019,25(03):271.
　TANG Hong-ying,LI Jing,SONG Yuan-yuan,et al.Related risk factors for infection and prognosis of Carbapenem-resistant Klebsiella pneumoniae[J].Journal of Tianjin Medical University,2019,25(06):271.
[3]郎磊,李娜,陈露,等.替加环素联合5种抗菌药物对耐碳青霉烯的肺炎克雷伯菌体外抗菌作用的研究[J].天津医科大学学报,2020,26(03):276.
　LANG Lei,LI Na,CHEN Lu,et al.In vitro antibacterial activity study of tigecycline combined with 5 antibacterial agents against CRKP[J].Journal of Tianjin Medical University,2020,26(06):276.

备注/Memo

备注/Memo:

作者简介 余倩（1989-），女，硕士在读，研究方向：细菌耐药机制；

通信作者：胡志东，E-mail: huzhidong27@163.com。

常用功能

更新日期/Last Update: 2015-11-27