Evaluation of the Performance of the MicroScan Pos Breakpoint Combo Panel Type 28 for Susceptibility Testing of Staphylococcus aureus: Low-range Minimum Inhibitory Concentration of Vancomycin, Cefoxitin Screening, and Inducible Clindamycin Resistance Detection
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background : Susceptibility testing of Staphylococcus aureus often requires cumbersome supplementary tests. MicroScan Pos Breakpoint Combo Panel Type 28 (PBC28) (Siemens, USA) includes cefoxitin screening to detect methicillin-resistant Staphylococcus aureus (MRSA), inducible clindamycin resistance detection (ICD), and determination of low-range minimum inhibitory concentration of vancomycin (0.5-16 mg/mL). The purpose of this study was to evaluate the performance of PBC28 in comparison with that of Pos Combo Type 1A (PC1A) (Siemens). Methods : From December 2009 to March 2010, 500 non-duplicate clinical isolates of S. aureus were tested with PC1A and PBC28. Categorical agreements (CA) between the interpretations of the 2 panels were estimated. The presence of the mecA gene was determined by PCR, and double-disk diffusion test (D-test) was performed on the isolates resistant to erythromycin but susceptible or intermediately resistant to clindamycin. Ninety-six isolates representing various vancomycin minimum inhibitory concentrations (MICs) were tested in parallel with repeat PBC28, broth macrodilution, and epsilometer test (E test). Results : The CA was 99.3% with a very major error (VME) of 0.2%, major error (ME) of 0.1%, and minor error (mE) of 0.4% in total. PBC28 showed 100% CA for 1 isolate with vancomycin MIC of 4 mg/mL and 35 isolates (7.0%) with MIC of 2 mg/mL. However, only 15, 27, and 35 isolates with vancomycin MIC of 2 mg/mL showed 100% CA in repeat PBC28, broth macrodilution, and E test, respectively. PC1A and PBC28 detected all 314 mecA-positive isolates. Among the 63 isolates tested with the D-test, 58 (92.1%) were positive, and the results were 100% concordant with those of ICD. Conclusions : PBC28 can be appropriate susceptibility testing of S. aureus, including MRSA detection and ICD. However, the lower-range vancomycin MIC test was not reproducible enough to reliably differentiate MIC of 2 mg/mL from MIC≤1 mg/mL. (Korean J Lab Med 2010; 30:637-46)
Abstract
Background : Susceptibility testing of Staphylococcus aureus often requires cumbersome supplementary tests. MicroScan Pos Breakpoint Combo Panel Type 28 (PBC28) (Siemens, USA) includes cefoxitin screening to detect methicillin-resistant Staphylococcus aureus (MRSA), inducible clindamycin resistance detection (ICD), and determination of low-range minimum inhibitory concentration of vancomycin (0.5-16 mg/mL). The purpose of this study was to evaluate the performance of PBC28 in comparison with that of Pos Combo Type 1A (PC1A) (Siemens). Methods : From December 2009 to March 2010, 500 non-duplicate clinical isolates of S. aureus were tested with PC1A and PBC28. Categorical agreements (CA) between the interpretations of the 2 panels were estimated. The presence of the mecA gene was determined by PCR, and double-disk diffusion test (D-test) was performed on the isolates resistant to erythromycin but susceptible or intermediately resistant to clindamycin. Ninety-six isolates representing various vancomycin minimum inhibitory concentrations (MICs) were tested in parallel with repeat PBC28, broth macrodilution, and epsilometer test (E test). Results : The CA was 99.3% with a very major error (VME) of 0.2%, major error (ME) of 0.1%, and minor error (mE) of 0.4% in total. PBC28 showed 100% CA for 1 isolate with vancomycin MIC of 4 mg/mL and 35 isolates (7.0%) with MIC of 2 mg/mL. However, only 15, 27, and 35 isolates with vancomycin MIC of 2 mg/mL showed 100% CA in repeat PBC28, broth macrodilution, and E test, respectively. PC1A and PBC28 detected all 314 mecA-positive isolates. Among the 63 isolates tested with the D-test, 58 (92.1%) were positive, and the results were 100% concordant with those of ICD. Conclusions : PBC28 can be appropriate susceptibility testing of S. aureus, including MRSA detection and ICD. However, the lower-range vancomycin MIC test was not reproducible enough to reliably differentiate MIC of 2 mg/mL from MIC≤1 mg/mL. (Korean J Lab Med 2010; 30:637-46)
참고문헌 (31)
- Lowy FD, "Staphylococcus aureus infections", N Engl J Med, 339, pp.520~532 (1998)
- Schito GC, "The importance of the development of antibiotic resistance in Staphylococcus aureus", Clin Microbiol Infect, 12(S1), pp.3~8 (2006)
- 이혁민, "2004년도 국내 12개 병원에서 분리된 주요 세균의 항균제 내성율", 대한임상미생물학회지, 8(1), pp.66~73 (2005), 대한임상미생물학회
- 김재석, "국내 13개 의료기관에서 수집된 Staphylococcus aureus의 항균제 감수성 양상", The Korean Journal of Laboratory Medicine, 24(4), pp.223~229 (2004), 대한진단검사의학회
- 이혁민, "2005∼2006년 국내 12개 병원에서 분리된 주요 세균의 항균제 내성률", 대한임상미생물학회지, 10(1), pp.59~69 (2007), 대한임상미생물학회
- Sakoulas G, "Methicillin-resistant Staphylococcus aureus: comparison of susceptibility testing methods and analysis of mecA-positive susceptible strains", J Clin Microbiol, 39, pp.3946~3951 (2001)
- Junkins AD, "BD Phoenix and Vitek 2 detection of mecAmediated resistance in Staphylococcus aureus with cefoxitin", J Clin Microbiol, 47, pp.2879~2882 (2009)
- Spanu T, "Identification of methicillin-resistant isolates of Staphylococcus aureus and coagulase-negative staphylococci responsible for bloodstream infections with the Phoenix system", Diagn Microbiol Infect Dis, 48, pp.221~227 (2004)
- Yamazumi T, "Comparison of the Vitek Gram-Positive Susceptibility 106 card and the MRSA-screen latex agglutination test for determining oxacillin resistance in clinical bloodstream isolates of Staphylococcus aureus", J Clin Microbiol, 39, pp.53~56 (2001)
- Clinical and Laboratory Standards Institute, "Performance standards for antimicrobial susceptibility testing. Twentieth informational supplement, M100-S20", Clinical and Laboratory Standards Institute, ~ (2010)
- 어영, "Distributions of Macrolide-Lincosamide-Streptogramin B Resistance Phenotypes in Clinical Isolates of Staphylococi", 대한임상미생물학회지, 11(2), pp.78~83 (2008), 대한임상미생물학회
- 임환섭, "Prevalence of Inducible Clindamycin Resistance in Staphylococcal Isolates at a Korean Tertiary Care Hospital", Yonsei Medical Journal, 47(4), pp.480~484 (2006), 연세대학교의과대학
- Lewis JS 2nd, "Inducible clindamycin resistance in staphylococci: should clinicians and microbiologists be concerned?", Clin Infect Dis, 40, pp.280~285 (2005)
- Leclercq R, "Mechanisms of resistance to macrolides and lincosamides:nature of the resistance elements and their clinical implications", Clin Infect Dis, 34, pp.482~492 (2002)
- Swenson JM, "Detection of inducible clindamycin resistance in staphylococci by broth microdilution using erythromycin-clindamycin combination wells", J Clin Microbiol, 45, pp.3954~3957 (2007)
- Hiramatsu K, "Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility", J Antimicrob Chemother, 40, pp.135~136 (1997)
- Vaudaux P, "Underestimation of vancomycin and teicoplanin MICs by broth microdilution leads to underdetection of glycopeptide-intermediate isolates of Staphylococcus aureus", Antimicrob Agents Chemother, 54, pp.3861~3870 (2010)
- Tenover FC, "Characterization of staphylococci with reduced susceptibilities to vancomycin and other glycopeptides", J Clin Microbiol, 36, pp.1020~1027 (1998)
- Hidayat LK, "High-dose vancomycin therapy for methicillin-resistant Staphylococcus aureus infections: efficacy and toxicity", Arch Intern Med, 166, pp.2138~2144 (2006)
- Soriano A, "Influence of vancomycin minimum inhibitory concentration on the treatment of methicillin-resistant Staphylococcus aureus bacteremia", Clin Infect Dis, 46, pp.193~200 (2008)
- Maclayton DO, "Casecontrol study of the relationship between MRSA bacteremia with a vancomycin MIC of 2 mg", mL and risk factors, costs, and outcomes in inpatients undergoing hemodialysis, 2006, pp.28, 1208~1216
- Clinical and Laboratory Standards Institute, "Development of in vitro susceptibility testing criteria and quality control parameters:approved guideline. 2nd ed", Clinical and Laboratory Standards Institute, ~ (2001)
- Hanaki H, "Occurrence of vancomycin-intermediate-resistant Staphylococcus aureus in Japan", J Infect Chemother, 13, pp.118~121 (2007)
- Yoon YK, "Predictors of persistent methicillin-resistant Staphylococcus aureus bacteraemia in patients treated with vancomycin", J Antimicrob Chemother, 65, pp.1015~1018 (2010)
- Wang G, "Increased vancomycin MICs for Staphylococcus aureus clinical isolates from a university hospital during a 5-year period", J Clin Microbiol, 44, pp.3883~3886 (2006)
- Hsu DI, "Comparison of method-specific vancomycin minimum inhibitory concentration values and their predictability for treatment outcome of meticillin-resistant Staphylococcus aureus (MRSA) infections", Int J Antimicrob Agents, 32, pp.378~385 (2008)
- Swenson JM, "Accuracy of commercial and reference susceptibility testing methods for detecting vancomycin-intermediate Staphylococcus aureus", J Clin Microbiol, 47, pp.2013~2017 (2009)
- Satola SW, "Staphylococcus aureus isolates with vancomycin MICs of 2 mg", mL by automated testing, 2009, pp.47, 2680~2681
- Webster D, "Methicillin-resistant Staphylococcus aureus with reduced susceptibility to vancomycin in Canada", Diagn Microbiol Infect Dis, 57, pp.177~181 (2007)
- Jones RN, "LEADER surveillance program results for 2006: an activity and spectrum analysis of linezolid using clinical isolates from the United States (50 medical centers)", Diagn Microbiol Infect Dis, 59, pp.309~317 (2007)
- Yun HJ, "Prevalence and mechanisms of low- and high-level mupirocin resistance in staphylococci isolated from a Korean hospital", J Antimicrob Chemother, 51, pp.619~623 (2003)