EUCAST和CLSI微量肉汤稀释法白念珠菌体外药物敏感性试验结果比较

doi:10.3969/j.issn.1673-8640.2022.010.013

摘要/Abstract

摘要：

目的比较欧洲抗菌药物敏感性试验委员会（EUCAST）和美国临床实验室标准化协会（CLSI）微量肉汤稀释法白念珠菌体外药物敏感性试验结果的差异。方法分别用EUCAST方法和CLSI方法检测42株白念珠菌对两性霉素B、阿尼芬净、卡泊芬净、氟康唑、伊曲康唑、伏立康唑、泊沙康唑和米卡芬净的敏感性，比较2种方法的基本一致性（EA）、分类一致性（CA）、极重大误差率（VME）和重大误差率（ME）。结果 EUCAST方法和CLSI方法总体EA为95.2%~100.0%，CA为95.2%~100.0%，ME为0%~4.8%，VME为0%~2.4%；氟康唑的ME为4.8%，泊沙康唑的VME为2.4%。结论 EUCAST方法和CLSI方法白念珠菌体外药物敏感性试验结果具有可比性，但部分药物之间需要额外的协调步骤。

关键词: 白念珠菌, 微量肉汤稀释法, 体外药物敏感性试验, 欧洲抗菌药物敏感性试验委员会, 美国临床实验室标准化协会

Abstract:

Objective To compare the results of susceptibility testing by European Committee on Antimicrobial Susceptibility Testing（EUCAST） and the Clinical and Laboratory Standards Institute（CLSI） broth microdilution methods against Candida albicans. Methods The susceptibilities of 42 isolates of Candida albicans were determined for amphotericin B，anidulafungin，caspofungin，fluconazole，itraconazole，voriconazole，posaconazole and micafungin according to EUCAST and CLSI methods. The essential agreement（EA），categorical agreement（CA），very major errors（VME） and major errors（ME）of the 2 methods were compared. Results The EA was 95.2%-100.0%. The CA，ME and VWE were 95.2%-100.0%，0%-4.8% and 0%-2.4%，respectively. The ME for fluconazole was 4.8%，and the VME for posaconazole was 2.4%. Conclusions The results of susceptibility testing by EUCAST and CLSI broth microdilution methods are comparable against Candida albicans. There are several areas where additional steps toward harmonization are warranted.

Key words: Candida albicans, Broth microdilution method, In vitro susceptibility testing, European Committee on Antimicrobial Susceptibility Testing, Clinical and Laboratory Standards Institute

中图分类号:

R379.4

张亚茹, 凌丽燕, 陈敏. EUCAST和CLSI微量肉汤稀释法白念珠菌体外药物敏感性试验结果比较[J]. 检验医学, 2022, 37(10): 974-978.

ZHANG Yaru, LING Liyan, CHEN Min. Comparison of EUCAST and CLSI broth microdilution methods for the susceptibility testing against Candida albicans[J]. Laboratory Medicine, 2022, 37(10): 974-978.

图/表 3

参考文献 22

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药物名称	MIC		EA/%		几何均数
药物名称	EUCAST方法/（mg/L）	CLSI方法/ （μg/mL）	±1浓度稀释梯度	±2浓度稀释梯度	EUCAST方法	CLSI方法
两性霉素B	0.25~2	0.5~2	88.1	100	0.600	1.104
阿尼芬净	0.008~0.032	0.008~0.064	95.2	100	0.010	0.019
卡泊芬净	0.016~2	0.016~2	90.5	100	0.044	0.024
氟康唑	0.0125~16	0.025~64	71.4	95.2	0.616	1.414
伊曲康唑	0.008~0.5	0.016~1	83.3	100	0.020	0.039
米卡芬净	0.008~0.32	0.015~0.64	78.5	97.6	0.010	0.022
泊沙康唑	0.008~0.5	0.0016~0.5	88.1	100	0.017	0.035
伏立康唑	0.008~0.032	0.016~0.064	97.6	100	0.013	0.023

药物名称	MIC		EA/%		几何均数
药物名称	EUCAST方法/（mg/L）	CLSI方法/ （μg/mL）	±1浓度稀释梯度	±2浓度稀释梯度	EUCAST方法	CLSI方法
两性霉素B	0.25~2	0.5~2	88.1	100	0.600	1.104
阿尼芬净	0.008~0.032	0.008~0.064	95.2	100	0.010	0.019
卡泊芬净	0.016~2	0.016~2	90.5	100	0.044	0.024
氟康唑	0.0125~16	0.025~64	71.4	95.2	0.616	1.414
伊曲康唑	0.008~0.5	0.016~1	83.3	100	0.020	0.039
米卡芬净	0.008~0.32	0.015~0.64	78.5	97.6	0.010	0.022
泊沙康唑	0.008~0.5	0.0016~0.5	88.1	100	0.017	0.035
伏立康唑	0.008~0.032	0.016~0.064	97.6	100	0.013	0.023

药物名称	CLSI折点/（μg/mL）				EUCAST折点/（mg/L）
药物名称	敏感	中介	剂量依赖性敏感	耐药	敏感	耐药
两性霉素B^①	≤2	NA	NA	>2	≤1	>1
阿尼芬净	≤0.25	0.5	NA	≥1	≤0.03	>0.03
卡泊芬净	≤0.25	0.5	NA	≥1	NA	NA
氟康唑	≤2	NA	4	≥8	≤2	>4
伊曲康唑^①	≤0.12	NA	NA	>0.12	≤0.06	>0.06
米卡芬净	≤0.25	0.5	NA	≥1	≤0.016	>0.016
泊沙康唑^①	≤0.06	NA	NA	>0.06	≤0.06	>0.06
伏立康唑	≤0.125	0.25~0.5	NA	≥1	≤0.06	>0.25

药物名称	CLSI折点/（μg/mL）				EUCAST折点/（mg/L）
药物名称	敏感	中介	剂量依赖性敏感	耐药	敏感	耐药
两性霉素B^①	≤2	NA	NA	>2	≤1	>1
阿尼芬净	≤0.25	0.5	NA	≥1	≤0.03	>0.03
卡泊芬净	≤0.25	0.5	NA	≥1	NA	NA
氟康唑	≤2	NA	4	≥8	≤2	>4
伊曲康唑^①	≤0.12	NA	NA	>0.12	≤0.06	>0.06
米卡芬净	≤0.25	0.5	NA	≥1	≤0.016	>0.016
泊沙康唑^①	≤0.06	NA	NA	>0.06	≤0.06	>0.06
伏立康唑	≤0.125	0.25~0.5	NA	≥1	≤0.06	>0.25

药物名称	敏感/[株（%）]		中介/[株（%）]		剂量依赖性敏感/[株（%）]		耐药/[株（%）]		CA/ %	ME/ %	VME/ %
药物名称	EUCAST 方法	CLSI 方法	EUCAST方法	CLSI 方法	EUCAST方法	CLSI 方法	EUCAST方法	CLSI 方法	CA/ %	ME/ %	VME/ %
两性霉素B	42（100.0）	42（100.0）					0（0）	0（0）	100.0	0.0	0.0
阿尼芬净	42（100.0）	42（100.0）		0（0）			0（0）	0（0）	100.0	0.0	0.0
卡泊芬净	36（85.7）	36（85.7）	2（4.8）			0（0）	4（9.5）	6（14.3）	95.2	4.8	0.0
氟康唑	34（80.9）	34（80.9）					8（19.0）	8（19.0）	100.0	0.0	0.0
伊曲康唑	42（100.0）	42（100.0）	0（0）	0（0）			0（0）	0（0）	100.0	0.0	0.0
米卡芬净	38（90.5）	37（84.1）					4（9.5）	5（11.9）	97.6	0.0	2.4
泊沙康唑	41（97.6）	41（97.6）	0（0）	1（2.4）			1（2.4）	0（0）	97.6	2.4	0.0