VITEK2 자동화 장비를 이용한 포도알균의 유도형 Clindamycin 내성 검출의 평가
Performance of the VITEK2 System for Detection of Inducible Clindamycin Resistance in Staphylococci
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배경: Clinical and Laboratory Standards Institute (CLSI) 지침은 clindamycin 감수성 혹은 중간이고, erythromycin 내성인 포도알균에 대해 D-zone test를 시행하여 유도성 clindamycin 내성을 검출할 것을 권장하고 있다. 최근 VITEK2 자동화 장비의 유도형 clindamycin 내성 검출이 도입되어 이를 D-zone test와 비교 평가하였다. 방법: 포도알균 142주를 대상으로 VITEK2 Antimicrobial Susceptibility Test (AST) - P601 card (bioMeriéux, Marcy l’Etoile,France)를 이용한 유도형 clindamycin 내성검사와 D-zone test를 비교하였다. 총 142주에서 114주[coagulase-negative staphylococci (CoNS) 40주, Staphylococcus aureus 74주]는 clindamycin 감수성 혹은 중간이고 erythromycin 내성인 포도알균이며, 28주(CoNS 1주, S. aureus 27주)는 clindamycin과 erythromycin 모두 내성 혹은 모두 감수성인 포도알균이었다. 결과: Clindamycin 감수성 혹은 중간이고 erythromycin 내성인 포도알균 114주에서 S. aureus의 98.6% (73/74), CoNS의32.5% (13/40)가 D-zone test 결과 유도형 clindamycin 내성이었다. D-zone test와 비교 시, 총 142주 포도알균에서 VITEK2자동화 장비의 민감도는 98.8% (85/86), 특이도는 98.2% (55/56)였다. VITEK2 자동화 장비와 D-zone test 간의 일치율은98.6% (140/142)였다. 결론: VITEK2 자동화 장비의 유도형 clindamycin 내성 검출은 D-zone test와 높은 일치율을 보였다. 따라서 포도알균의유도형 clindamycin 내성은 VITEK2 장비를 이용하여 쉽고 편리하게 검출할 수 있을 것이다. [대한임상미생물학회지2010;13:157-161]
Abstract
Background: The Clinical and Laboratory Standards Institute (CLSI) recommends testing for inducible clindamycin resistance in clindamycin non-resistant and erythromycin resistant (CNR-ER) staphylococci by using a D-zone test. Recently, the VITEK2 system was developed to detect inducible clindamycin resistance in staphylococci. We evaluated the performance of the VITEK2 system by comparing it with a D-zone test. Methods: In detecting inducible clindamycin resistance,a total of 142 clinical isolates of staphylococci were tested by using the VITEK2 Antimicrobial Susceptibility Test (AST)-P601 card (bioMérieux, Marcy l’Etoile, France) and the D-zone test. Of the 142 isolates of staphylococci tested, 114 were CNR-ER staphylococci [40 coagulase-negative staphylococci (CoNS),74 Staphylococcus aureus] and 28 were staphylococci,either resistant or susceptible to clindamycin and erythromycin (1 CoNS and 27 S. aureus). Results: Of the 114 CNR-ER staphylococci, 98.6%(73/74) of S. aureus and 32.5% (13/40) of CoNS were inducible clindamycin resistant according to the Dzone test. Overall sensitivity and specificity of the VITEK2system were 98.8% (85/86) and 98.2% (55/56) respectively,and the agreement between the VITEK2system and the D-zone test was 98.6% (140/142). Conclusion: The VITEK2 system shows high concordance with a D-zone test. The inducible clindamycin resistance in staphylococci can be detected easily and conveniently by the VITEK2 system. (Korean J Clin Microbiol 2010;13:157-161)
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