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目的评价E试验(E-test)法检测淋球菌对5种药物敏感性的临床价值。方法对2014年深圳市淋球菌耐药监测项目收集的100株该地区淋球菌临床分离株,分别采用琼脂稀释法、E-test以及纸片扩散法(K-B法)进行头孢曲松、青霉素、大观霉素、环丙沙星以及阿奇霉素药敏试验,以琼脂稀释法结果作为标准,评价E-test与琼脂稀释法结果的一致率,比较E-test与K-B法的误差率及相关性。结果 E-test与琼脂稀释法测得的100株淋球菌对五种抗生素的50%最小抑菌浓度MIC50、MIC90以及MIC值范围大多完全相同或仅相差0.5~1.5个稀释度,两种方法具有较高的基本一致率(72%~98%),其中一致率最高的是环丙沙星(98%),其次是阿奇霉素(92%),一致率最低的是青霉素(72%)。除青霉素E-test误差率(22%)高于K-B法(12%)外,其余四种抗生素E-test的误差率均低于K-B法,且与琼脂稀释法的相关性高于K-B法。结论环丙沙星和阿奇霉素的E-test可以作为琼脂稀释法的替代方法应用于临床,头孢曲松和大观霉素的E-test可能导致结果偏低,而青霉素由于同时具有较低的一致率和较高的误差率,则不适宜采用。
Objective To evaluate the clinical value of E-test in detecting the sensitivity of Neisseria gonorrhoeae to five drugs. Methods A total of 100 clinical isolates of Neisseria gonorrhoeae collected from Shenzhen Neisseria gonorrhoeae drug resistance surveillance project in 2014 were divided into two groups: ceftriaxone, penicillin, Ciprofloxacin and azithromycin susceptibility test, agar dilution method as a standard evaluation of E-test and agar dilution results of the agreement rate, E-test and KB error rate and correlation. Results The MIC50, MIC90 and MIC of 100 strains of Neisseria gonorrhoeae on the five antibiotics measured by E-test and agar dilution method were mostly the same or only differ by 0.5-1.5 dilutions. The two methods had The highest consistent rates (72% -98%) were ciprofloxacin (98%) followed by azithromycin (92%) and penicillin (72%) with the lowest concordance rate. The error rates of the other four antibiotics E-test were lower than that of K-B method except that the error rate of penicillin E-test (22%) was higher than that of K-B method (12%). Conclusions E-test of ciprofloxacin and azithromycin can be used clinically as an alternative to agar dilution. E-test of ceftriaxone and spectinomycin may result in lower results, whereas penicillin, due to the low concordance rate And a higher error rate, it is not suitable.