周世平, 李情操, 卢雯君, 洪思伟. VITEK2-Compact专家系统修正肠杆科细菌药敏结果的可靠性探讨[J]. 上海预防医学, 2019, 31(10): 813-816. DOI: 10.19428/j.cnki.sjpm.2019.19070
引用本文: 周世平, 李情操, 卢雯君, 洪思伟. VITEK2-Compact专家系统修正肠杆科细菌药敏结果的可靠性探讨[J]. 上海预防医学, 2019, 31(10): 813-816. DOI: 10.19428/j.cnki.sjpm.2019.19070
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ZHOU Shi-ping, LI Qing-cao, LU Wen-jun, HONG Si-wei. Accuracy of revising the results of drug sensitivity detection by experts in VITEK2 automatic microbial analysis system[J]. Shanghai Journal of Preventive Medicine, 2019, 31(10): 813-816. DOI: 10.19428/j.cnki.sjpm.2019.19070
Citation: ZHOU Shi-ping, LI Qing-cao, LU Wen-jun, HONG Si-wei. Accuracy of revising the results of drug sensitivity detection by experts in VITEK2 automatic microbial analysis system[J]. Shanghai Journal of Preventive Medicine, 2019, 31(10): 813-816. DOI: 10.19428/j.cnki.sjpm.2019.19070
shu

VITEK2-Compact专家系统修正肠杆科细菌药敏结果的可靠性探讨

Accuracy of revising the results of drug sensitivity detection by experts in VITEK2 automatic microbial analysis system

    摘要
  • 摘要:
    目的评估VITEK2分析系统检测肠杆科细菌药敏结果专家系统修正的准确性，以判断此药敏结果能否满足临床需求。
    方法选择经VITEK2试卡法检测和专家系统修正的46株大肠埃希菌、29株肺炎克雷伯菌和12株奇异变形杆菌，采用纸片扩散法(K-B法)进行检测，并与VITEK2试卡法检测结果进行对比分析。
    结果2种方法对头孢他啶、头孢吡肟和氨曲南的药敏结果符合率，大肠埃希菌分别为63.0%、47.8%和58.7%，肺炎克雷伯菌分别为37.9%、41.4%和34.5%，奇异变形杆菌分别为91.7%、83.3%和100.0%；大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌对头孢吡肟的药敏结果严重错误(VME)率均最高，分别为30.4%、44.8%和8.3%；ESBLS确证试验阳性率差异无统计学意义(P>0.05)。
    结论对VITEK2分析系统检测并经专家系统修正的抗菌药物仪器检测结果，可采用K-B法确证试验加以确认，不应盲目采用专家系统加以修正，而应结合临床疗效如实报告VITEK2分析系统检测结果或K-B法结果，同时对药敏结果进行注评。

     

    Abstract:
    ObjectiveTo evaluate the accuracy of the modified drug sensitivity results of VITEK2 analysis system and to determine whether the drug sensitivity results can meet the clinical needs.
    MethodsA total of 46 strains of Escherichia coli, 29 strains of Klebsiella pneumoniae and 12 strains of Proteus mirabilis were detected by VITEK2 test card method.Ceftazidime, cefepime and aztreonam were detected by K-B method.The results of VITEK2 test-card method were compared with reference method-K-B method.
    ResultsWith two methods for ceftazidime, cefepime and aztreonam, the drug sensitivity coincidence rates were 63.0%, 47.8% and 58.7% for Escherichia coli, 37.9%, 41.4% and 34.5% for Klebsiella pneumoniae, 91.7%, 83.3% and 100.00% for Proteus mirabilis, respectively.The largest VME of Escherichia coli was 30.4% to cefepime, those of Klebsiella pneumoniae was 44.8% to cefepime, those of Proteus mirabilis was 8.3% to cefepime.There was no significant difference in the positive rate of ESBLs confirmation test (P>0.05).
    ConclusionK-B method should be used to confirm the test results of VITEK2 analysis system and modified by AES, and the expert system should not be blindly used to correct the results.The results of VITEK2 analysis system or K-B method should be reported according to the clinical efficacy and the results of drug sensitivity should be evaluated at the same time.

     

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