Evaluation of direct and standard antimicrobial susceptibility testing methods on some bacteria isolated from automated blood cultures
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Dosyalar
Tarih
2003
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmada otomatize kan kültürlerinden izole edilen bakteriler için direkt ve standart antimikrobiyal duyarlılık testlerinin karşılaştırılması amaçlanmıştır. 2001-2002 yılında 12 aylık dönemde bakteremi kuşkulu 126 hastadan alınan kan kültürleri değerlendirmeye alınmıştır. Üreme sinyali veren şişelerden alınan örnekler Gram boyama sonucuna göre Gram-olumlu kümeli kok ya da Gram-negatif basil (GNB) olarak belirlenmiş ve Müller Hinton ağara direkt inokülasyon yöntemi ile antibiyogram yapılmıştır. Kültür sonucu pozitif olduğu halde Gram boyama sonucu negatif olan, kültürde birden fazla bakteri üreyen ve Gram boyama sonucu pozitif olan örnekler çalışma kapsamına alınmamıştır. Direkt disk difüzyon testi sonuçları standart Kirby-Bauer disk difüzyon testi sonuçları ile karşılaştırmıştır. Her iki yöntem arasındaki uyumsuzluk çok büyük hata, büyük hata ve küçük hata olarak sınıflandırılmıştır. Staphylococcus aureus ve koagülaz-negatif stafilokoklar için iki yöntem arasında toplam uyum, sırasıyla, %92.2 ve %90.7 olarak bulunmuştur. Stafilokok türleri için toplam çok büyük hata %2.5, büyük hata %1.3 ve küçük hata %0.6 olarak saptanmıştır. Gram-negatif basil ve Pseudomonas için toplam uyum sırasıyla, %92.1 ve %96.8 olarak belirlenmiştir. Gram-negatif basil için toplam çok büyük hata %1.5, büyük hata %0.7 ve küçük hata %1.3 olarak bulunmuştur. Sonuç olarak; direkt disk difüzyon testi uygulama kolaylığı, santrifüj, preinkübasyon ve inokulasyon standardizasyonu gerektirmemesi nedeniyle diğer hızlı yöntemlere üstünlüğü olan ve özellikle GNB ve oksasiline dirençli S. aureus'un neden olduğu bakteremilerde hızlı tanı ve erken tedavi için yararlı olabilecek bir yöntemdir. Direkt yöntem, kan kültürlerinden izole edilen GNB ve stafilokok türleri için duyarlılık paterninin erkenden belirlenmesinde standart prosedürlere ek olarak kullanılabilir.
'The aim of this study is to evaluate direct and standardized antimicrobial susceptibility testing methods for the detection of bacteria isolated from automated blood cultures. In accordance with the protocol of the study, 126 blood cultures were collected from the patients during a 12-month period in 2001-2002. The samples from positive bottles showing growth of Gram-negative bacilli or clustered Gram-positive cocci, determined by Gram staining, were used for direct inoculation onto Mueller Hinton agar. The negative smears which had positive cultures and the positive smears which showed mixed cultures were excluded from the study. The results of direct disk diffusion tests were compared with those of standard Kirby-Bauer disk diffusion method, and discrepancies were classified as very major, major, or minor errors. The overall agreement of the two methods for Staphvlococcus aureus and coagulase-negative staphylococci, In terms of the interpretive categories (susceptible, intermediate, and resistant) were 92.2 % and 90.7%, respectively. There were 32 (2.5%) very major errors, 16 (1.3%) major errors and eight (0.6%) minor errors which were caused by the direct method for Staphvlococus spp. The overall agreement of the two methods for Enterobacteriaceae and Pseudomonas spp. in terms of the interpretive categories were 92.1% and 96.8%, respectively. There were 22 (1.5%) very major errors, 11 (0.7%) major errors and 19 (1.3%) minor errors caused by direct method for Gram-negative bacilli. The rapid method for the antimicrobial susceptibility testing of Gram-negative bacilli and oxacilline resistant S. aureus is simple and requires no centrifugation, preincubation, or standardization of the inocula. This method can be used for patients with bacteremia. The direct disk method is proposed as a test that can be used as a supplement to the standardized procedures for the earlier determination of the susceptibility patterns of aerobic Gram-negative bacilli and Stapjiylococcus spp. from blood cultures.
'The aim of this study is to evaluate direct and standardized antimicrobial susceptibility testing methods for the detection of bacteria isolated from automated blood cultures. In accordance with the protocol of the study, 126 blood cultures were collected from the patients during a 12-month period in 2001-2002. The samples from positive bottles showing growth of Gram-negative bacilli or clustered Gram-positive cocci, determined by Gram staining, were used for direct inoculation onto Mueller Hinton agar. The negative smears which had positive cultures and the positive smears which showed mixed cultures were excluded from the study. The results of direct disk diffusion tests were compared with those of standard Kirby-Bauer disk diffusion method, and discrepancies were classified as very major, major, or minor errors. The overall agreement of the two methods for Staphvlococcus aureus and coagulase-negative staphylococci, In terms of the interpretive categories (susceptible, intermediate, and resistant) were 92.2 % and 90.7%, respectively. There were 32 (2.5%) very major errors, 16 (1.3%) major errors and eight (0.6%) minor errors which were caused by the direct method for Staphvlococus spp. The overall agreement of the two methods for Enterobacteriaceae and Pseudomonas spp. in terms of the interpretive categories were 92.1% and 96.8%, respectively. There were 22 (1.5%) very major errors, 11 (0.7%) major errors and 19 (1.3%) minor errors caused by direct method for Gram-negative bacilli. The rapid method for the antimicrobial susceptibility testing of Gram-negative bacilli and oxacilline resistant S. aureus is simple and requires no centrifugation, preincubation, or standardization of the inocula. This method can be used for patients with bacteremia. The direct disk method is proposed as a test that can be used as a supplement to the standardized procedures for the earlier determination of the susceptibility patterns of aerobic Gram-negative bacilli and Stapjiylococcus spp. from blood cultures.
Açıklama
Anahtar Kelimeler
Automated Blood Cultures, Bacteria, Direct Antimicrobial Susceptibility Testing, Standard Antimicrobial Susceptibility Testing, Disk Diffusion Method, Otomatize Kan Kültürleri, Bakteriler, Direkt Antimikrobiyal Duyarlılık Testi, Standart Antimikrobiyal Duyarlılık Testi, Disk Difizyon Yöntemi
Kaynak
İnfeksiyon Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
17
Sayı
3
