Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
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Evaluation of MicroScan Synergies plus Positive Combo 3 Panels for Identification and Antimicrobial Susceptibility Testing of Staphylococcus aureus and Enterococcus Species

  • Jung, Hai-Young (Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Nam-Yong (Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2010.01.28
  • Accepted : 2010.07.09
  • Published : 2010.08.31
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Abstract

Background : Few studies have evaluated the performance of the recently introduced MicroScan Synergies plus Positive Combo 3 Panels (SIPC3) (Dade Behring Inc., USA). We evaluated the clinical efficacy of the panels in identification (ID) and antimicrobial susceptibility testing (AST) of Staphylococcus aureus and enterococci. Methods : To evaluate the panels' accuracy of identification, the results obtained using the test panels were compared with those obtained by using conventional biochemical tests in conjunction with VITEK 2 system (bio-Merieux, USA). In addition, the AST results obtained using the panels were compared with those obtained by performing CLSI broth microdilution. Results : The overall agreement between the approaches for the ID of S. aureus and enterococci was 100% and 96%, respectively. The categorical and essential agreements (CA and EA) for S. aureus were 98%, each. Very major errors (VME), major errors (ME), and minor error (mE) for S. aureus were 0.45%, 0.3%, and 4.2%, respectively. The majority of VMEs were for oxacillin (8.6%), penicillin (2.0%), erythromycin (7.9%), clindamycin (3.8%), and tetracycline (4.1%). For enterococci, the CA, EA, VME, ME, and mE were 88.8%, 93.7%, 4.4%, 0%, and 2.8%, respectively. The 80.5% (29/36) of Enterococcus faecium had concordant ID with the reference. Most of the categorical errors (3 VMEs and 14 mEs) were observed for quinupristin/dalfopristin (Synercid; Catalytica Pharmaceuticals Inc., USA). Conclusions : The panels compared favorably with conventional methods for the ID and AST of S. aureus. However, we expected a better performance for ID of E. faecium and AST using Synercid.

배경 : MicroScan Synergies plus Positive Combo 3 Panels (SIPC3) (Dade Behring Inc., USA)이 최근 새롭게 개발되었지만 이에 대한 평가 연구가 저조한 상황이다. 이에 본 연구에서는 황색포도알균과 장알균의 동정과 항균제강수성검사에 MicroScan SIPC3의 유용성을 평가하고자 한다. 방법 : 통상적인 생화학 검사 및 VITEK 2 system (bio-Merieux, USA)을 이용하여 확정 동정되어 보관중인 황색포도알균(N=100)과 장알균(N=100)을 대상으로 MicroScan SIPC3을 이용하여 동정과 항균제감수성검사를 실시하였다. 항균제감수성검사는 CLSI 표준법인 미량액체배지희석법으로 검사하여 결과를 비교하였다. 결과 : 황색포도알균과 장알균의 전체 동정률은 각각 100%와 96%였다. 황색포도알균의 일치한 결과(essential agreement, EA)와 범주일치율(categorical agreement, CA)은 모두 98%였다. 황색포도알균의 very major errors (VME), major errors (ME), minor error (mE)는 각각 0.45%, 0.3%, 4.2%였다. VME의 대부분에 해당되는 항생제는 oxacillin, penicillin, erythromycin, clindamycin, tetracycline으로 이들의 VME는 각각 8.6%, 2.0%, 7.9%, 3.8%, 4.1%였다. 장알균의 CA, EA, VME, ME, mE은 88.8%, 93.7%, 4.4%, 0%, 2.8%였다. E. faecium의 동정일치율은 80.5%로 낮은 성적을 보였고, 범주불일치의 대부분은 quinupristin/dalfopristin (Synercid Catalytica pharmaceuticals Inc., USA)에 의한 것으로 3개의 VME와 14개의 mE를 나타냈다. 결론 : 본 연구는 통상적 생화학적 검사와 표준법인 미량액체 배지희석법을 MicroScan SIPC3의 결과와 비교함으로 새로운 MicroScan SIPC3의 진단적 효율성을 평가한 최초의 연구이다. MicroScan SIPC3는 통상적 생화학적 검사 및 표준방법과 비교할 만한 신뢰성을 보여주는 검사 방법이지만, E. faecium의 동정과 장알균에 대한 Synercid 감수성 검사에 대해서는 향상이 필요할 것으로 생각된다.

Keywords

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