혈액에서 분리되는 칸디다 균주에 대한 ATB FUNGUS 2와 VITEK-2 항진균제감수성검사(AST-YS01)의 비교
Comparison of ATB FUNGUS 2 and VITEK-2 Antifungal Susceptibility (AST-YS01) Tests for Candida Species Isolated from Blood Culture
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배경: 최근 VITEK-2 시스템에서 항진균제감수성검사를 실시하는 제품인 AST-YS01 (bioMerieux, Hazelwood, MO, USA)이 소개되었는데, 이는 자동화된 분광광도계를 이용하여 MIC 판독을 실시함으로써 주관적 오류를 최소화한 제품이다. 저자들은 혈액배양에서 분리된 칸디다 균주를 대상으로 ATB FUNGUS 2와 VITEK-2 항진균제 감수성 검사를 실시하고이 성적을 CLSI M27법과 비교 평가하여 보았다. 방법: 2008년 9월부터 2009년 8월까지 원주기독병원의 혈액배양에서 분리된 칸디다 59주를 대상으로 하였다. 각 균주는ATB FUNGUS 2, VITEK-2를 이용한 AST-YS01, CLSI M27법의 액체배지 미량희석법으로 amphotericin B, flucytosine, fluconazole,voriconazole을 검사하여 MIC 성적을 비교하였다. 결과: 희석 2배수 내에서 ATB FUNGUS 2와 VITEK-2 (AST-YS01)의 CLSI M27법과의 항진균제별 일치율은 amphotericin B와 flucytosine은 모두 100%였고, fluconazole은 83.6%와 98.3%였으며, voriconazole은 83.6%와 96.7%였다. Fluconazole과voriconazole의 판정 범주 오차는 ATB FUNGUS 2에서 20.4%와 18.6%였고, VITEK-2 (AST-YS01)에서는 6.8%와 0%였다. Fluconazole과 voriconazole은 모두 very major error와 major error가 없었다. 결론: VITEK-2 시스템을 이용한 자동화된 항진균제 감수성 검사인 AST-YS01는 신속하게 결과를 얻을 수 있으며 CLSI 표준방법과의 일치율이 높아 일반검사실에서 유용하게 사용될 수 있을 것으로 생각된다. [대한임상미생물학회지2010;13:114-120]
Abstract
Background: The VITEK-2 yeast susceptibility test (AST-YS01; bioMérieux, Hazelwood, MO, USA) has recently been introduced as a fully automated, commercial antifungal susceptibility test system that determines MIC endpoints spectrophotometrically, thereby eliminating subjective errors. We compared the ATB FUNGUS 2 (bioMérieux) and VITEK-2 (ASTYS01)systems to the CLSI M27 method for susceptibility testing of Candida isolates. Methods: We tested 59 Candida species that were isolated from blood cultures at Wonju Christian Hospital between September 2008 and August 2009. We compared MIC results for amphotericin B, flucytosine,fluconazole and voriconazole using the ATB FUNGUS 2 and VITEK-2 (AST-YS01) tests to those obtained by the CLSI M27 broth microdilution method. Results: Within two-fold dilutions of MICs, the agreement of the ATB FUNGUS 2 and VITEK-2 (ASTYS01)tests with the CLSI method according to antifungal agents were: amphotericin B, 100% vs. 100%flucytosine, 100% vs. 100% fluconazole, 83.6% vs. 98.3% and voriconazole, 83.6% vs. 96.7%, respectively. The categorical discrepancies for fluconazole and voriconazole were 20.4% and 18.6% for ATB FUNGUS 2, and 6.8% and 0% for VITEK-2(ASTYS01). There were no major errors for fluconazole and voriconazole in either ATB FUNGUS 2 or VITEK-2 (ASTYS01) tests. Conclusion: The VITEK-2 system (AST-YS01) appears to be rapid and highly correlative with the CLSI method, suggesting that it is effective for antifungal susceptibility testing for Candida species in clinical settings. (Korean J Clin Microbiol 2010;13:114-120)
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