Objective: To evaluate the agreement between TDR-300B Plus automatic microbial analysis system and the existing clinical microbial analysis system for identification and antimicrobial susceptibility test of clinical oxidase-negative gram-negative bacilli (ONGNB). Methods: The TDR-300B Plus analysis system and matched Enterobacteriaceae ID&AST Kit were adopted to proceed identification and antimicrobial susceptibility test of ONGNB, and results of MALDI-TOF and VITEK 2 compact AST-GN13 were used as the controls. The Kappa value was calculated and McNemar test was performed to evaluate the agreement between TDR-300B Plus and controls. 16S rRNA sequencing was used as the final identification when there was an inconsistent result between TDR-300B and MALDI-TOF. The CLSI M07-A9 broth microdilution method was used as the final for antimicrobial susceptibility test when the susceptibility result of TDR -300B Pluswas obviously different from VITEK (S/R or R/S). Results: Identification of 209 strains of ONGNB showed that results of TDR-300B Plus had good consistency with those of the control method (Kappa values >0.90, and McNemar P values >0.05). Antimicrobial susceptibility tests showed that among the 14 antimicrobials, the complete agreement (CA) of 10 were above 90% apart from aztreonam （ATM）(86.02%), ceftazidime （CAZ）(85.79%), cefepime(FEP) (82.63%) and tigecycline(TGC) (82.76%). The almost agreement(AA) of all the antimicrobials were >90%. Except TGC (Kappa=0.704 8), the Kappa of the others were >0.80, with only 3 (ATM, CAZ and FEP ) having a McNemar P values <0.05. The total MD was 3.16%, and Escherichia coli (29/48) appeared to be the most. The most frequent type of MD was R/S/R(36/48) with CAZ and FEP the most common. The total very major disagreement(VMD) was 2.87%. The most frequent type of VMD was S/R/S (14/21), with meropenem(MEM) and sulphamethoxazole/trimethoprim(SXT) the most common. Conclusions: For identification and antimicrobial susceptibility test of ONGNB, results of TDR-300B Plus have high agreements with those of existing microbial analysis system, which can be served as a supplement and ensure routine clinical work smoothly.
WANG Su, ZHU Dedong, SUN Jingyong, HAN Lizhong
. Identification and antimicrobial susceptibility test of clinical oxidase-negative gram-negative bacilli with TDR-300B Plus automatic microbial analysis system[J]. Journal of Diagnostics Concepts & Practice, 2017
, 16(01)
: 48
-54
.
DOI: 10.16150/j.1671-2870.2017.01.010
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