临床微生物实验室药敏纸片片间均匀性差异的实时监测和药敏质控试验频率的动态调整

发布时间：2018-01-11 18:18

本文关键词：临床微生物实验室药敏纸片片间均匀性差异的实时监测和药敏质控试验频率的动态调整　出处：《中国抗生素杂志》2016年06期 　论文类型：期刊论文

【摘要】：目的在临床微生物实验室,建立对药敏纸片质量和片间均匀性差异进行实时监测,并对药敏质量控制试验频率进行动态调整的参考方法。方法通过多纸片重复试验和MIC测定对3种少见药敏谱和4种不合理药敏模式进行研究和分析,寻找其产生的内在原因。结果当重复药敏试验与初次药敏试验结果不一致,且重复试验药敏纸片间抑菌圈直径最大值与最小值的差大于3mm时,提示为该药敏纸片片间均匀性差异太大,需更换批次、批号并与厂家联系;当重复药敏试验与常规药敏试验结果不一致,且重复试验药敏纸片间抑菌圈直径最大值与最小值的差小于等于3mm时,提示需对药敏质量控制试验频率进行动态调整。结论那些非"少见药敏谱或不合理药敏模式"的药敏结果也同样存在药敏纸片质量问题和片间均匀性差异问题,且在日常工作中更难以发现。每家实验室都应根据自身的特点和具体情况,制定相应的方案,对药敏纸片质量和片间差进行时时监测,对质量控制试验频率进行动态调整,以确保实验的准确性和可重复性。
[Abstract]:Objective to establish a real-time monitoring of the quality and uniformity of drug-sensitive tablets in clinical microbiology laboratory. Methods three rare drug sensitive spectra and four irrational drug susceptibility patterns were studied and analyzed by repeated multidisk test and MIC measurement in order to dynamically adjust the frequency of drug sensitive quality control test. Results when the results of the repeated drug sensitivity test and the initial drug sensitivity test were inconsistent, and the difference between the maximum and minimum diameter of the bacteriostasis circle was more than 3 mm. It is suggested that there is too much difference in uniformity between the pieces of the drug sensitive paper, so it is necessary to change the batches, batch numbers and contact with the manufacturers. When the results of repeated drug sensitivity test and routine drug sensitivity test were inconsistent, and the difference between the maximum and minimum diameter of bacteriostasis circle was less than or equal to 3 mm. It is suggested that the frequency of drug sensitive quality control test should be adjusted dynamically. Conclusion the quality problems of drug sensitive tablets and the difference of uniformity between tablets also exist in those drug sensitive results which are not "rare drug sensitivity spectrum or unreasonable drug sensitivity pattern". It is more difficult to find in the daily work. Each laboratory should make corresponding plan according to its own characteristics and specific conditions to monitor the quality of drug-sensitive paper tablets and the difference between tablets from time to time. The frequency of quality control test is adjusted dynamically to ensure the accuracy and repeatability of the experiment.
【作者单位】：苏州大学附属第一医院;
【分类号】：R446.5
【正文快照】： 抗菌药物敏感性试验(antimicrobial susceptibilitytest,AST)对感染性疾病的治疗起着至关重要的作用,它为患者用药的安全性和有效性提供了保证。Kirby-Bauer(K-B)法是标准化药敏试验方法之一,也是目前我国临床实验室最常用的AST方法。K-B法的影响因素很多,其中药敏纸片的质量

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