The capabilities of disc diffusion and Vitek-2 Compact methods for testing antimicrobial susceptibility of Burkholderia cepacia

doi:10.3877/cma.j.issn.1674-1358.2018.06.010

Abstract

Abstract:

Objective

To evaluate the capabilities of disc diffusion and Vitek-2 Compact methods for testing antimicrobial susceptibility of Burkholderia cepacia.

Methods

Total of 34 isolates of Burkholderia cepacia were collected from January 2017 to December 2017 in Shaoxing People’s Hospital, the vitro minimum inhibition concentration (MIC) values of ceftazidime, compound sulfamethoxazole, levofloxacin, piperacillin/tazobactam, tetracycline, meropenem, chloramphenicol, minocycline and cefperidone/sulbactam were detected by disc diffusion method, Vitek-2 Compact method and broth microdilution method, respectively. Categorical agreement (CA) rates of disc diffusion and Vitek-2 Compact methods were determined, taking broth microdilution method as the reference method.

Results

The 95% confidence intervals (95%CI) of ceftazidime, compound sulfamethoxazole, levofloxacin, meropenem and chloramphenicol were 6.2-13.2, 0.5-0.8, 3.8-6.3, 3.7-7.3 and 5.0-10.0, respectively, detected by broth microdilution method. The CA values of disc diffusion for ceftazidime, compound sulfamethoxazole, tigocycline, chloramphenicol and minocycline antibiotics were all > 90%, compared with broth microdilution method, Disc diffusion method and Vitek-2 Compact method were taken to detect the sensitivity of piperacillin/tazobactam in vitro, and the rate of agreement with reference method was the lowest, all < 80%. The major error (ME) of Vitek-2 Compact for detection of Tegafycline was 50%. Taken the broth microdilution method as the standard, the best antimicrobial agent in vitro was compound sulfamethoxazole and minocycline (all 100%), and the most sensitive antibacterials were levofloxacin (38.2%).

Conclusions

The drug sensitivity of Burkholderia cepacia detected by disk diffusion method and Vitek-2 Compact instrument method both had good reliability to ceftazidime and compound sulfamethoxazole. Ateention should be paid to the possible occurrence of very major error (VME) and ME, when antimicrobial susceptibility of piperacillin/tazobactam and cefoperazone/sulbactam were detected by disk diffusion method.

Key words: Burkholderia cepacia, Disc diffusion method, Vitek-2, Broth microdilution method, Categorical agreement

Guofeng Mao, Meichun Liang. The capabilities of disc diffusion and Vitek-2 Compact methods for testing antimicrobial susceptibility of Burkholderia cepacia[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2018, 12(06): 570-576.

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References 25

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抗菌药物	样本编号	KB法		VITEK-2法		微量肉汤稀释法
抗菌药物	样本编号	结果判读	解释	结果判读	解释	结果判读
头孢他啶	9	S	MIE	R	MIE	I
?	10	S	MIE	R	MIE	I
?	13	I	—	R	MIE	I
?	17	S	MIE	I	—	I
?	21	S	MIE	I	—	I
?	24	S	—	S	—	S
?	25	S	—	S	—	S
左氧氟沙星	8	R	—	I	MIE	R
?	10	S	MIE	I	—	I
?	15	S	VME	S	VME	R
?	25	R	—	R	—	R
?	28	S	MIE	I	—	I
?	31	I	MIE	I	MIE	S
哌拉西林/他唑巴坦	1	S	VME	R	—	R
?	3	I	MIE	R	—	R
?	5	S	—	R	ME	S
?	7	S	VME	R	—	R
?	9	S	VME	R	—	R
?	10	S	VME	R	—	R
?	11	S	—	R	ME	S
?	14	R	ME	R	ME	S
?	15	S	—	R	ME	S
?	16	S	—	R	ME	S
?	17	S	VME	R	—	R
?	18	S	—	R	ME	S
?	19	S	VME	R	—	R
?	20	S	—	R	ME	S
?	21	S	—	R	ME	S
?	22	S	—	R	ME	S
?	23	S	—	R	ME	S
?	24	S	VME	R	—	R
?	25	S	VME	R	—	R
?	26	S	VME	R	—	R
?	27	S	VME	R	—	R
?	31	I	MIE	R	—	R
替加环素	8	I	—	R	MIE	I
?	21	I	MIE	R	ME	S
?	22	S	—	I	MIE	S
?	26	I	MIE	R	ME	S
?	27	S	—	R	ME	S
?	28	I	MIE	S	—	S
?	30	S	—	R	ME	S
?	33	I	—	R	MIE	I
?	34	I	—	R	MIE	I
美罗培南	2	I	MIE	—	—	R
?	8	R	ME	—	—	S
?	10	S	MIE	—	—	I
?	15	S	MIE	—	—	I
?	22	S	MIE	—	—	I
?	24	S	—	—	—	S
?	25	S	MIE	—	—	I
?	31	S	—	—	—	S
?	33	S	—	—	—	S
氯霉素	5	S	—	—	—	S
?	12	S	—	—	—	S
?	19	S	—	—	—	S
?	23	I	MIE	—	—	R
?	28	I	MIE	—	—	R
米诺环素	8	I	MIE	—	—	S
?	15	S	—	—	—	S
头孢哌酮/舒巴坦	7	S	MIE	—	—	I
?	14	I	—	—	—	I
?	21	R	ME	—	—	S
?	24	S	MIE	—	—	I
?	25	S	—	—	—	S
?	26	S	VME	—	—	R
?	28	S	MIE	—	—	I

抗菌药物	样本编号	KB法		VITEK-2法		微量肉汤稀释法
抗菌药物	样本编号	结果判读	解释	结果判读	解释	结果判读
头孢他啶	9	S	MIE	R	MIE	I
?	10	S	MIE	R	MIE	I
?	13	I	—	R	MIE	I
?	17	S	MIE	I	—	I
?	21	S	MIE	I	—	I
?	24	S	—	S	—	S
?	25	S	—	S	—	S
左氧氟沙星	8	R	—	I	MIE	R
?	10	S	MIE	I	—	I
?	15	S	VME	S	VME	R
?	25	R	—	R	—	R
?	28	S	MIE	I	—	I
?	31	I	MIE	I	MIE	S
哌拉西林/他唑巴坦	1	S	VME	R	—	R
?	3	I	MIE	R	—	R
?	5	S	—	R	ME	S
?	7	S	VME	R	—	R
?	9	S	VME	R	—	R
?	10	S	VME	R	—	R
?	11	S	—	R	ME	S
?	14	R	ME	R	ME	S
?	15	S	—	R	ME	S
?	16	S	—	R	ME	S
?	17	S	VME	R	—	R
?	18	S	—	R	ME	S
?	19	S	VME	R	—	R
?	20	S	—	R	ME	S
?	21	S	—	R	ME	S
?	22	S	—	R	ME	S
?	23	S	—	R	ME	S
?	24	S	VME	R	—	R
?	25	S	VME	R	—	R
?	26	S	VME	R	—	R
?	27	S	VME	R	—	R
?	31	I	MIE	R	—	R
替加环素	8	I	—	R	MIE	I
?	21	I	MIE	R	ME	S
?	22	S	—	I	MIE	S
?	26	I	MIE	R	ME	S
?	27	S	—	R	ME	S
?	28	I	MIE	S	—	S
?	30	S	—	R	ME	S
?	33	I	—	R	MIE	I
?	34	I	—	R	MIE	I
美罗培南	2	I	MIE	—	—	R
?	8	R	ME	—	—	S
?	10	S	MIE	—	—	I
?	15	S	MIE	—	—	I
?	22	S	MIE	—	—	I
?	24	S	—	—	—	S
?	25	S	MIE	—	—	I
?	31	S	—	—	—	S
?	33	S	—	—	—	S
氯霉素	5	S	—	—	—	S
?	12	S	—	—	—	S
?	19	S	—	—	—	S
?	23	I	MIE	—	—	R
?	28	I	MIE	—	—	R
米诺环素	8	I	MIE	—	—	S
?	15	S	—	—	—	S
头孢哌酮/舒巴坦	7	S	MIE	—	—	I
?	14	I	—	—	—	I
?	21	R	ME	—	—	S
?	24	S	MIE	—	—	I
?	25	S	—	—	—	S
?	26	S	VME	—	—	R
?	28	S	MIE	—	—	I

抗菌药物	纸片含量（μg）	纸片扩散法（mm）			MIC法（μg/ml）
抗菌药物	纸片含量（μg）	S	I	R	S	I	R
头孢他啶	30	≥ 21	18～20	≤ 17	≤ 8	16	≥ 32
美罗培南	10	≥ 20	16～19	≤ 15	≤ 4	8	≥ 16
米诺环素	30	≥ 19	15～18	≤ 14	≤ 4	8	≥ 16
左氧氟沙星	5	≥ 17	14～16	≤ 13	≤ 2	4	≥ 8
复方磺胺甲噁唑	25	≥ 16	11～15	≤ 10	≤ 2/38	…	≥ 4/76
氯霉素	30	≥ 18	13～17	≤ 12	≤ 8	16	≥ 32
头孢哌酮舒巴坦	105	≥ 21	16～20	≤ 15	≤ 16/4	32/4	≥ 64/4
哌拉西林他唑巴坦	110	≥ 21	18～20	≤ 17	≤ 16/4	32/4～64/4	≥ 128/4
替加环素	15	≥ 16	13～15	≤ 12	≤ 2	4	≥ 8

抗菌药物	纸片含量（μg）	纸片扩散法（mm）			MIC法（μg/ml）
抗菌药物	纸片含量（μg）	S	I	R	S	I	R
头孢他啶	30	≥ 21	18～20	≤ 17	≤ 8	16	≥ 32
美罗培南	10	≥ 20	16～19	≤ 15	≤ 4	8	≥ 16
米诺环素	30	≥ 19	15～18	≤ 14	≤ 4	8	≥ 16
左氧氟沙星	5	≥ 17	14～16	≤ 13	≤ 2	4	≥ 8
复方磺胺甲噁唑	25	≥ 16	11～15	≤ 10	≤ 2/38	…	≥ 4/76
氯霉素	30	≥ 18	13～17	≤ 12	≤ 8	16	≥ 32
头孢哌酮舒巴坦	105	≥ 21	16～20	≤ 15	≤ 16/4	32/4	≥ 64/4
哌拉西林他唑巴坦	110	≥ 21	18～20	≤ 17	≤ 16/4	32/4～64/4	≥ 128/4
替加环素	15	≥ 16	13～15	≤ 12	≤ 2	4	≥ 8

检测方法	头孢他啶	美罗培南	复方磺胺甲噁唑	左氧氟沙星	氯霉素
纸片扩散法（mm）	26.4～35.1	23.3～32.1	26.4～33.7	12.3～21.8	25.8～32.2
仪器法（μg/ml）	8.8～23.8	ND	1.1～1.5	3.6～6.0	ND
微量肉汤稀释法（μg/ml）	6.2～13.2	3.7～7.3	0.5～0.8	3.8～6.3	5.0～10.0
检测方法	米诺环素	头孢哌酮舒巴坦	哌拉西林他唑巴坦	替加环素
纸片扩散法（mm）	25.8～32.5	18.3～30.8	25.2～36.3	16.1～17.8
仪器法（μg/ml）	ND	ND	39.4～82.3	5.0～6.0
微量肉汤稀释法（μg/ml）	1.1～2.1	38.9～101.3	61.9～128.3	1.0～2.1

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