폐렴알균의 항균제 감수성검사를 위한 Phoenix System의 평가
Evaluation of the BD Phoenix Automated Microbiology System SMIC/ID-2 Panel for Antimicrobial Susceptibility Testing of Streptococcus pneumoniae
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배경 : 항균제에 내성을 보이는 폐렴알균(Streptococcus pneumoniae) 이 증가함에 따라 적절한 항균제 치료를 위해서는 정 확하고 자동화된 항균제 감수성검사법이 필요하다. 본 연구에서 는 BD Phoenix Automated Microbiology system (Beckton Dickinson Diagnostic Systems, USA)의 SMIC/ID-2 panel 을 이용하여 폐렴알균의 항균제 감수성검사를 시행하여 그 유용 성을 평가하고자 하였다. 방법 : 다양한 임상 검체에서 분리된 폐렴알균 113주(2008 CLSI 판정 기준으로 penicillin 감수성 88주, 중간 8주, 내성 17 주)를 대상으로 하였다. Penicillin, cefotaxime, clindamycin, erythromycin, levofloxacin, trimethoprim/sulfamethoxazole, tetracycline, vancomycin의 8가지 항균제에 대해 Etest (AB Biodisk, Sweden)와 Phoenix를 이용한 항균제 감수성검 사를 시행한 후 두 방법에 의해 얻어진 최소억제농도(Minimum inhibitory concentration, MIC)를 비교 분석하였다. 결과 : Etest와 비교하여 Phoenix system의 MIC의 전체적 인 일치율은 92.3%이었다. Very major error와 major error 는 관찰되지 않았으며 minor error는 6.5%였다. Minor error 는 penicillin (22.1%), cefotaxime (12.4%), trimethoprim/sulfamethoxazole (11.5%)에서 빈번하게 관찰되었다. 결론 : Phoenix SMIC/ID-2 panel을 이용한 폐렴알균 항균 제 감수성검사는 빠르고 간편하게 MIC를 얻을 수 있을 뿐만 아 니라, Etest와 비교하여 대부분의 항균제에서 높은 일치율을 보 여 임상미생물검사실에서 유용하게 쓰일 수 있는 자동화 검사법 으로 생각된다.
Abstract
Background : With the emergence of antimicrobial resistance among Streptococcus pneumoniae, a more accurate and automated antimicrobial susceptibility testing method is essential. We evaluated the BD Phoenix Automated Microbiology System (Becton Dickinson Diagnostic Systems, USA) SMIC/ID-2 panel for antimicrobial susceptibility testing of S. pneumoniae. Methods : A total of 113 clinical strains of S. pneumoniae (88 penicillin susceptible strains, 8 intermediate strains, and 17 resistant strains by 2008 CLSI criteria) were tested. Minimum inhibitory concentrations (MICs) for penicillin, cefotaxime, clindamycin, erythromycin, levofloxacin, trimethoprim/ sulfamethoxazole, tetracycline, and vancomycin were determined by Etest (AB Biodisk, Sweden) and Phoenix System. The results obtained by Phoenix system were compared to those obtained by Etest. Results : The overall essential agreement of MICs (within one dilution of MICs) defined by the Phoenix and Etest was 92.3%. Neither very major errors nor major errors were produced, and minor errors were 6.5%. Minor errors were frequently observed in susceptibility testings for penicillin (22.1%), cefotaxime (12.4%), and trimethoprim/sulfamethoxazole (11.5%). Conclusions : The Phoenix SMIC/ID-2 panel provided a simple and rapid susceptibility testing for S. pneumoniae, and the results were in a good agreement with those of Etest. The Phoenix system appears to be an effective automated system in clinical microbiology laboratories.
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