Klebsiella Pneumoniae ve Acinetobacter Baumannii Suşlarında Kolistin Duyarlılığının Saptanması: Yöntem Karşılaştırması

Abstract

Amaç: Bu çalışma ile çok ilaca dirençli Gram negatif bakterilerde kolistin duyarlılığı için sıvı mikrodilüsyon (SMD) temelli ticari sistem ile kolistin sıvı disk elüsyon (KSDE) yöntemlerinin karşılaştırılması amaçlanmıştır. Araçlar ve Yöntem: Mart 2020 - Haziran 2022 tarihleri arasında çeşitli klinik örneklerden izole edilen 112 K. pneumoniae ve 62 A. baumannii izolatı çalışmaya alınmıştır. Suşların kolistin duyarlılıkları SMD temelli ticari sistem ve KSDE yöntemleri ile karşılaştırılmıştır. Bulgular: K. pneumoniae izolatlarının KSDE test sonuçları ile SMD temelli ticari kit sonuçları arasında çok iyi uyum bulunmuştur (κ=0.88). A. baumannii izolatlarının KSDE test sonuçları ile SMD temelli ticari kit sonuçları karşılaştırıldığında ise önemsiz düzeyde uyum bulunmuştur (κ=0.11). Sonuç: Klebsiella izolatlarında KSDE yönteminin kolistin duyarlılığının belirlenmesinde uyumu yüksektir. Acinetobacter izolatlarında ise uyum düzeyinin düşük olması altın standart SMD yöntemine alternatif, rutin laboratuvarda uygulanabilir yöntemlere ihtiyaç olduğunu göstermektedir.

Keywords

• antibiyotik duyarlılık
• disk elüsyon
• kolistin
• sıvı mikrodilüsyon

Detection of Colistin Susceptibility in Klebsiella Pneumoniae and Acinetobacter Baumannii Strains: Method Comparison

Abstract

Purpose: The aim of this study was to compare the broth microdilution method (BMD)-based commercial system and colistin broth disk elution method (CBDE) for colistin susceptibility in multidrug resistant Gram-negative bacteria. Materials and methods: 112 K. pneumoniae and 62 A. baumannii isolates which were isolated from various clinical specimens between March 2020 and June 2022 were included in the study. The colistin susceptibilities of the strains were compared with BMD-based commercial system and CBDE methods. Results: For K. pneumoniae isolates, a very good agreement was found between the results of the KSDE test and those of the commercially available SMD-based kit (κ=0.88). However, for A. baumannii isolates, there was a negligible level of agreement between the results of the KSDE test and the commercially available SMD-based kit (κ=0.11). Conclusions: The CBDE method is highly compatible in determining the colistin susceptibility of Klebsiella species. The low level of agreement in Acinetobacter isolates indicates that new methods that can be applied in the routine laboratory as an alternative to the gold standard BMD method, are needed.

Keywords

• antibiotic sensitivity
• broth microdilution
• colistin
• disk elution

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