Catry Boudewijn, Dewulf Jeroen, de Kruif Aart, Vanrobaeys Mia, Haesebrouck Freddy, Decostere Annemie
Department of Reproduction, Obstetrics and Herd Health, Ghent University, 9820 Merelbeke, Belgium.
Microb Drug Resist. 2007 Fall;13(3):204-11. doi: 10.1089/mdr.2007.721.
The accuracy of antimicrobial susceptibility determinations relies on the bacterial species identification and the test methodology that is being used. In the present study, both aspects were investigated for 141 Pasteurella multocida and 34 Mannheimia haemolytica sensu lato isolates recovered from the upper respiratory tract of healthy calves. This was performed on the one hand by comparing of classical phenotyping with tDNA-PCR genotyping and on the other hand by pairwise comparison of disk diffusion with agar dilution results for seven antimicrobial compounds (ampicillin, ceftiofur, oxytetracycline, gentamicin, florfenicol, enrofloxacin, and the combination trimethoprim-sulfonamides). Phenotyping and genotyping correlated well (>90%). The pairwise comparisons of the susceptibility methods were investigated traditionally by means of error binding rates and sensitivity and specificity test characteristics. Obtained sensitivities (indication for absence of false susceptible results) were often lower than 85%, especially for older antimicrobial agents (oxytetracycline, gentamicin, trimethoprim-sulfonamides) and when M. haemolytica sensu lato was considered. Specificities (indication for absence of false-resistant results) exceeded 90% for almost all antimicrobial-bacterial combinations. The calculated test characteristics (sensitivities and specificities) were subsequently used in a second dataset of Pasteurellaceae from intensively (n = 99) and extensively housed calves (n = 196), to modify the apparent prevalence of antimicrobial resistance based upon disk diffusion results into an estimated true prevalence. It was concluded that the disk diffusion method is reliable in epidemiological studies like surveillance programs if resistance is sparse, whereas it needs to be interpreted with caution in situations where resistance is abundantly present.
抗菌药物敏感性测定的准确性取决于细菌种类鉴定和所使用的检测方法。在本研究中,对从健康犊牛上呼吸道分离出的141株多杀性巴氏杆菌和34株溶血曼氏杆菌(广义)菌株的这两个方面进行了研究。一方面,通过将经典表型分析与tDNA-PCR基因分型进行比较来完成;另一方面,对七种抗菌化合物(氨苄西林、头孢噻呋、土霉素、庆大霉素、氟苯尼考、恩诺沙星以及甲氧苄啶-磺胺甲恶唑组合)的纸片扩散法和琼脂稀释法结果进行成对比较。表型分析和基因分型相关性良好(>90%)。敏感性方法的成对比较传统上是通过误差结合率以及敏感性和特异性检测特征来研究的。获得的敏感性(表明不存在假敏感结果)通常低于85%,尤其是对于较老的抗菌药物(土霉素、庆大霉素、甲氧苄啶-磺胺甲恶唑)以及考虑溶血曼氏杆菌(广义)时。几乎所有抗菌-细菌组合的特异性(表明不存在假耐药结果)都超过了90%。随后,将计算出的检测特征(敏感性和特异性)用于来自集约化饲养(n = 99)和粗放式饲养犊牛(n = 196)的巴斯德菌科的第二个数据集,以便将基于纸片扩散结果的抗菌药物耐药性表观流行率修正为估计的真实流行率。得出的结论是,如果耐药性较少,纸片扩散法在诸如监测计划等流行病学研究中是可靠的,而在耐药性大量存在的情况下则需要谨慎解释。