2015年全国VITEK-2细菌药敏检测系统药敏试验结果准确性调查研究

发布时间：2018-03-08 01:12

本文选题：VITEK-　切入点：药敏试验　出处：《中华医院感染学杂志》2016年10期 　论文类型：期刊论文

【摘要】：目的调查全国细菌耐药监测网中使用VITEK-2药敏检测系统的医院微生物实验室药敏检测结果的准确性。方法向参加调研的425所医院的微生物实验室同时发放两株编号分别为Carss-14-QC001(产ESBLs大肠埃希菌)和Carss-14-QC002(产KPC肺炎克雷伯菌)的质控测试菌株,以微量肉汤稀释法作为参考方法,通过计算各实验室药敏结果基本一致性(EA)、分类一致性(CA)、非常重大误差(VME)、重大误差(ME)和小误差(mE)分析评估参评实验室药敏结果测定的准确性。结果 Carss-14-QC001的药敏测试结果:氨苄西林/舒巴坦和头孢曲松的EA(24.7%、51.6%)和CA(21.9%、79.2%)较低,其他抗菌药物的EA和CA值均90.0%;氨苄西林、氨苄西林/舒巴坦、头孢曲松、头孢替坦和磺胺甲VA唑/甲氧苄啶各出现一个VME结果;仅一个参评实验室(0.3%)的ESBL检测结果错误;Carss-14-QC002药敏结果:头孢替坦的EA(24.6%)和CA(21.2%)最低,美罗培南和头孢吡肟的EA(81.0%和82.1%)和CA(41.0%和76.9%)较低,其他抗菌药物的EA和CA均90.0%;美罗培南VME百分率为6.2%,其余抗菌药物VME百分率较低为0~1.2%;抗菌药物对二株测试菌株药敏结果的ME均较低为0~0.7%。结论全国VITEK-2细菌药敏检测系统中氨苄西林/舒巴坦、头孢曲松、头孢替坦、美罗培南和头孢吡肟的药敏检测结果一致性和准确性较低,其他抗菌药物的药敏结果均具有很好的一致性和较高的准确性。
[Abstract]:Objective to investigate the accuracy of drug sensitivity test results of microbiological laboratories using VITEK-2 drug sensitivity detection system in the national bacterial drug resistance monitoring network. Methods two strain numbers were issued to the microbiological laboratories of 425 hospitals participating in the study at the same time. The quality control test strains were Carss-14-QC001 (ESBLs producing Escherichia coli) and Carss-14-QC002 (KPC producing Klebsiella pneumoniae), respectively. The method of minim broth dilution was used as reference method. The accuracy of drug sensitivity test in laboratory was evaluated by calculating the basic consistency of drug sensitivity results in each laboratory, classification consistency, very important error, significant error and small error. Results the drug sensitivity test of Carss-14-QC001 was carried out. Results: the EAA of ampicillin / sulbactam and ceftriaxone were lower than that of ampicillin / sulbactam and ceftriaxone. The EA and CA values of other antimicrobial agents were 90.0.The results of ampicillin, ampicillin / sulbactam, ceftriaxone, ceftitan and sulfamethoxazole / trimethoprim showed one VME result respectively. The results of ESBL were wrong in only one laboratory. (Carss-14-QC002 results: EAA 24.6B of ceftitan) and CAG21.2) were the lowest, while those of meropenem and cefepime were 81.0% and 82.1%, and CAANG41.0% and 76.9B were lower. EA and CA of other antimicrobial agents were 90.0. The percentage of meropenem VME was 6.2. The percentage of other antimicrobial agents VME was lower than that of other antimicrobial agents. The ME of antimicrobial agents to the two strains tested was lower than that of other antimicrobial agents. Conclusion the results of VITEK-2 bacterial susceptibility detection line in China are lower than that of other antimicrobial agents. Ampicillin / sulbactam, The drug sensitivity of ceftriaxone, ceftitan, meropenem and cefepime was lower than that of other antimicrobial agents.
【作者单位】：中国医学科学院北京协和医院检验科国家卫生计生委合理用药专家委员会全国细菌耐药监测网质量管理中心;国家卫生计生委临床检验中心;解放军总医院微生物科;
【基金】：国家科技重大专项基金资助项目(2014ZX09507009-028)
【分类号】：R446.5

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