Vitek System과 디스크확산법을 이용한 Enterobacteriaceae에대한Piperacillin-Tazobactam과 Methicillin 내성 황색포도구균에 대한 Trimethoprim-Sulfamethoxazole 감수성시험의 평가
Evaluation of Vitek and Disk Diffusion Susceptibility Testing of Enterobacteriaceae against Piperacillin-Tazobactam and Methicillin-Resistant S. aureus against Trimethoprim Sulfamethoxazole
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배경：Vitek system을 이용한 Enterobacteriaceae에 대한 piperacillin-tazobactam (TZP)과 methicillin 내성황색포도구균(MRSA)에 대한 trimethoprim-sulfamethoxazole (SXT) 감수성 시험의 정확성을 액체배지 미량 희석법을 표준방법으로 하여 디스크확산법과 함께 평가하고자 하였다. 방법：96주의 Enterobacteriaceae (48 Escherichia coli, 26 Klebsiella pneumoniae, 8 Serratia marcescens, 6 Enterobacter cloacae, 2 E. aerogenes, 2 K. oxytoca, 2 Citrobacter freundii, 2 Pantoea agglomerans)와 61주의 MRSA를 대상으로 각각 TZP와 SXT에 대하여 Vitek system과 디스크확산법으로 감수성시험을 하였고 National Committee for Clinical Laboratory Standards의 액체배지 미량희석법을 표준검사로 시험하였다. 결과：Enterobacteriaceae에 대한 TZP 감수성시험 결과 Vitek은 10주(10%)가 minor error이었고 디스크확산법은 한주(1%)가 very major error, 13주(14%)가 minor error이었다. MRSA에 대한 SXT 감수성시험의 범주 일치율(categorical agreement)은 Vitek과 디스크확산법 모두 100%이었다. MIC의 희석배수를 기준으로 Vitek의 결과를 액체배지 미량희석법과 비교하였을 때, 희석배수 일치율(±1배 희석배수 이하)은 Enterobacteriaceae에 대한 TZP 감수성시험에서는 93%이었고, MRSA에 대한 SXT 감수성시험에서는 98%이었다. 결론：Vitek system과 디스크확산법의 Enterobacteriaceae에 대한 TZP와 MRSA에 대한 SXT의 감수성시험 결과는 비교적 정확하였다.
Abstract
Background: The aim of this study was to evaluate the Vitek system and the disk diffusion method for susceptibility testing of Enterobacteriaceaeagainst piperacillin-tazobactam (TZP) and methicillin-resistant Staphylococcus aureus (MRSA) against trimethoprim-sulfamethoxazole (SXT) using the broth microdilution method as the reference. Methods: Using the Vitek system and the disk diffusion method, we tested 96 isolates of Enterobacteriaceae(48 Escherichia coli, 26 Klebsiella pneumoniae, 8 Serratia marcescens, 6 Enterobacter cloacae, 2 E. aerogenes, 2 K. oxytoca, 2 Citrobacter freundii, 2 Pantoea agglomerans) and 61 isolates of MRSA for susceptibity against TZP and SXT, respectively; the broth microdilution of National Committee for Clinical Laboratory Standards was used as the reference method. Results: In the susceptibility testing of Enterobacteriaceae against TZP, Vitek system yielded 10(10%) minor errors, and the disk diffusion method one (1%) very major and 13 (14%) minor errors. For the MRSA against SXT, the rate of categorical agreement between the reference method and the Vitek or the disk diffusion method was both 100%. The rates of agreement between the reference method and the Vitek system in term of MICs (within ±1 dilution) were 93% and 98% in the susceptibility testing of Enterobacteriaceae against TZP and MRSA against SXT, respectively. Conclusion: Both Vitek system and disk diffusion method showed an acceptable level of accuracy for the susceptibility test of Enterobacteriaceaeagainst TZP and MRSA against SXT.
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