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BACTEC 혈액배양병 양성검체에서 직접접종법에 의한 균종동정과 항균제감수성검사를 위한 MicroScan과 Phoenix 시스템의 평가

Evaluation of MicroScan and Phoenix System for Rapid Identification and Susceptibility Testing Using Direct Inoculation from Positive BACTEC Blood Culture Bottles

성흥섭|전홍선|정재우|김미나*
대한진단검사의학회 (Korean Society For Laboratory Medicine)|2009.02|Annals of Laboratory Medicine|제29권 제1호|pp. 25-34

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키워드

IdentificationSusceptibilityPhoenixBlood cultureMicroScanDirect inoculation
주제분류병리학

초록

서론 : 혈액배양에서 직접접종법은 아직 표준화되어 있지 않 다. 본 연구는 BACTEC 9240 시스템(BD, USA)을 이용한 혈액 배양의 종동정과 감수성검사에서 MicroScan (Dade Behring, USA)과 Phoenix (BD, USA)의 직접접종법 수행능을 평가하였다. 방법 : 2006년 5월부터 6월까지 BACTEC 9240에서 양성인 혈액배양병 중 그람양성알균(gram positive cocci, GPC)이나 그람음성막대균(gram negative rods, GNR) 한 종만이 관찰된 검체의 균 침사를 GPC은 MicroScan PosCombo Panel Type 1A와 Phoenix PMIC/ID-107에, GNR은 MicroScan Neg- Combo Panel Type 32와 Phoenix NMIC/ID-53에 직접 접종 하였고, 표준접종법은 양성배양액을 혈액한천배지에 하룻밤 계 대배양한 집락을 이용하여 동일한 조건으로 검사하였다. 각 기 기 내 및 두 기기 간에서 직접법의 표준법에 대한 균동정과 항 균제감수성결과 일치율을 알아보았다. 결과 : MicroScan 108검체, Phoenix 104검체에 대해 평가 가 이루어졌고, 두 기기 모두에서 평가가 이루어진 경우는 78검 체였다. GPC에서 직접법의 종동정 일치율은 MicroScan 94.8%, Phoenix 80.7%, GNR에서는 각각 93.9%, 95.7%이었다. GPC 의 항균제감수성결과의 일치율은 MicroScan은 1,150 균주-항 균제조합에 대해 94.6%, Phoenix는 660조합에 대해 96.5%의 일치율을 보였고, 중대오류(very major error, VME)는 각각 1.1씩이었다. GNR은 MicroScan이 942조합에서 94.4%, Phoenix는 781조합에서 96.3%의 일치율을 나타냈고, VME는 각각 0.6%, 0% 등이었다. 기기간 직접법 종동정/항균제감수성결과를 비교할 때 Staphylococcus aureus 81.8%/98.0%, Escherichia coli 100.0%/95.6%가 일치하였다. 결론 : MicroSan은 GPC와 GNR의 종동정이 신뢰할 만 하 였고, Phoenix 직접법은 GNR에는 우수하였으나, GPC에 적용 하기는 어려웠다.

Abstract

Background : Procedures for rapid identification and susceptibility testing by direct inoculation (DI) from positive blood culture bottles into an automated system have not been standardized. This study was purposed to evaluate DI from BACTEC 9240 blood culture system (BD, USA) into MicroScan (Dade Behring, USA) or Phoenix (BD, USA). Methods : From May to June 2006, bacterial pellets from positive aerobic bottles showing grampositive cocci (GPC) or gram-negative rods (GNR) of single morphology were directly inoculated to MicroScan PosCombo1A and NegCombo32 and to Phoenix PMIC/ID-107 and NMIC/ID-53. In addition, the automated instruments were also inoculated from subcultures (standard inoculations, SI). Species identification and susceptibilities were compared between DI and SI and between MicroScan and Phoenix. Results : A total of 108, 104, and 78 specimens were tested with MicroScan, Phoenix, and both, respectively. When DI and SI were matched, 94.8% of GPC were correctly identified with MicroScan, compared to 80.7% with Phoenix, and 93.9% of GNR were correctly identified with MicroScan, compared to 95.7% with Phoenix. DI with MicroScan and Phoenix showed correct susceptibilities in 94.6% of 1,150 and 96.5% of 660 tests (with very major error [VME] of 1.1% and 1.1%), respectively, among GPC and in 94.4% of 942 and 96.3% of 781 tests (with VME of 0.6% and 0%), respectively, of GNR. Correlation of identification/susceptibilities between MicroScan and Phoenix using DI were 81.8%/98.0% for Staphylococcus aureus and 100.0%/95.6% for Escherichia coli. Conclusions : DI warrants a reliable method for identification and susceptibility testing of both GPC and GNR in MicroScan, and those of only GNR in Phoenix.

참고문헌 (28)

  1. Trenholme GM, "Clinical impact of rapid identification and susceptibility testing of bacterial blood culture isolates", J Clin Microbiol, 27, pp.1342~1345 (1989)
  2. Moore DF, "Rapid identification and antimicrobial susceptibility testing of gram-negative bacilli from blood cultures by the AutoMicrobic system", J Clin Microbiol, 13, pp.934~939 (1981)
  3. Mylotte JM, "Blood cultures: clinical aspects and controversies", Eur J Clin Microbiol Infect Dis, 19, pp.157~163 (2000)
  4. Weinstein MP, "Current blood culture methods and systems: clinical concepts, technology, and interpretation of results", Clin Infect Dis, 23, pp.40~46 (1996)
  5. Sung H, "The clinical relevance of four-day blood cultures with the BACTEC 9240 system", Korean J Clin Pathol, 21, pp.193~198 (2001)
  6. Edberg SC, "Rapid identification of Enterobacteriaceae from blood cultures with the Micro-ID system", J Clin Microbiol, 10, pp.693~697 (1979)
  7. Bruins MJ, "Identification and susceptibility testing of Enterobacteriaceae and Pseudomonas aeruginosa by direct inoculation from positive BACTEC blood culture bottles into Vitek 2", J Clin Microbiol, 42, pp.7~11 (2004)
  8. Funke G, "Use of the BD PHOENIX Automated Microbiology System for direct identification and susceptibility testing of gram-negative rods from positive blood cultures in a threephase trial", J Clin Microbiol, 42, pp.1466~1470 (2004)
  9. Kerremans JJ, "Accuracy of identification and susceptibility results by direct inoculation of Vitek 2 cards from positive BACTEC cultures", Eur J Clin Microbiol Infect Dis, 23, pp.892~898 (2004)
  10. Ling TK, "Evaluation of the VITEK 2 system for rapid direct identification and susceptibility testing of gram-negative bacilli from positive blood cultures", J Clin Microbiol, 41, pp.4705~4707 (2003)
  11. Waites KB, "Direct bacterial identification from positive BacT", Alert blood cultures using Micro-Scan overnight and rapid panels, 1998, pp.32, 21~26
  12. Facklam R, "What happened to the streptococci: overview of taxonomic and nomenclature changes", Clin Microbiol Rev, 15, pp.613~630 (2002)
  13. Clinical and Laboratory Standards Institute, "Performance standards for antimicrobial susceptibility testing. Seventeenth informational supplement (M100-S17)" (2007), Clinical and Laboratory Standards Institute
  14. Dipersio JR, "Direct identification and susceptibility testing of gram-negative bacilli from BACTEC bottles by use of the MS-2 system with updated bacterial identification software", J Clin Microbiol, 20, pp.1202~1204 (1984)
  15. de Cueto M, "Use of positive blood cultures for direct identification and susceptibility testing with the vitek 2 system", J Clin Microbiol, 42, pp.3734~3738 (2004)
  16. Huang TD, "Direct identification and susceptibility testing of gram-positive cocci from positive Bactec blood cultures with BD Phoenix Automated Microbiology System", Clin Microbiol Infect, 12, pp.S442~ (2006)
  17. Grant CE, "Evaluation of two commercial systems for identification of coagulasenegative staphylococci to species level", Diagn Microbiol Infect Dis, 18, pp.1~5 (1994)
  18. Ieven M, "Rapid and economical method for species identification of clinically significant coagulase-negative staphylococci", J Clin Microbiol, 33, pp.1060~1063 (1995)
  19. Perl TM, "Comparison of identification systems for Staphylococcus epidermidis and other coagulase-negative Staphylococcus species", Diagn Microbiol Infect Dis, 18, pp.151~155 (1994)
  20. Poyart C, "Rapid and accurate species-level identification of coagulase-negative staphylococci by using the sodA gene as a target", J Clin Microbiol, 39, pp.4296~4301 (2001)
  21. Renneberg J, "Evaluation of Staph ID 32 system and Staph-Zym system for identification of coagulase-negative staphylococci", J Clin Microbiol, 33, pp.1150~1153 (1995)
  22. Hayward NJ, "Effect of inoculum size on ampicillin and amoxycillin susceptibility determined by gas-liquid chromatography for members of the family Enterobacteriaceae", J Clin Microbiol, 23, pp.755~759 (1986)
  23. Waites KB, "Direct susceptibility testing with positive BacT", Alert blood cultures by using Micro-Scan overnight and rapid panels, 1998, pp.36, 2052~2056
  24. Murray P, "Manual of clinical microbiology. 7th ed", pp.1593~1600 (1999), American Society for Microbiology
  25. Donay JL, "Evaluation of the automated phoenix system for potential routine use in the clinical microbiology laboratory", J Clin Microbiol, 42, pp.1542~1546 (2004)
  26. Tenover FC, "Ability of commercial and reference antimicrobial susceptibility testing methods to detect vancomycin resistance in enterococci", J Clin Microbiol, 33, pp.1524~1527 (1995)
  27. Fontanals D, "Evaluation of wider system for direct identification and antimicrobial susceptibility testing of gram-negative bacilli from positive blood culture bottles", Eur J Clin Microbiol Infect Dis, 21, pp.693~695 (2002)
  28. Putnam LR, "Accuracy of the Vitek system for antimicrobial susceptibility testing Enterobacteriaceae bloodstream infection isolates: use of "direct"inoculation from Bactec 9240 blood culture bottles", Diagn Microbiol Infect Dis, 28, pp.101~104 (1997)

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