Multicentre evaluation of the VITEK 2 Advanced Expert System for interpretive reading of antimicrobial resistance tests.

Details

Ressource 1Download: serval:BIB_F98605C4A843.P001 (109.38 [Ko])
State: Public
Version: author
License: Not specified
It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_F98605C4A843
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Multicentre evaluation of the VITEK 2 Advanced Expert System for interpretive reading of antimicrobial resistance tests.
Journal
The Journal of Antimicrobial Chemotherapy
Author(s)
Livermore D.M., Struelens M., Amorim J., Baquero F., Bille J., Canton R., Henning S., Gatermann S., Marchese A., Mittermayer H., Nonhoff C., Oakton K.J., Praplan F., Ramos H., Schito G.C., Van Eldere J., Verhaegen J., Verhoef J., Visser M.R.
ISSN
0305-7453
Publication state
Published
Issued date
02/2002
Peer-reviewed
Oui
Volume
49
Number
2
Pages
289-300
Language
english
Notes
Publication types: Evaluation Studies ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Abstract
Interpretive reading analyses the complete resistance profiles of bacteria to multiple antibiotics and infers the resistance mechanisms present; it aids therapeutic choice and enhances surveillance data. We evaluated the Advanced Expert System (AES), which interprets MICs generated by the VITEK 2. Ten European laboratories tested 42 reference strains and 76-106 of their own strains, representing important resistance genotypes. Interpretive reading by the VITEK 2 AES achieved full agreement with genotype data for 88-89% of strains, with the correct mechanism identified as one of two possibilities for a further 5-6%. Mechanisms inferred with 90% agreement with reference data included methicillin resistance in staphylococci, glycopeptide resistance in enterococci, quinolone resistance in staphylococci and Enterobacteriaceae, AAC(6')-APH(2")-mediated aminoglycoside resistance in Gram-positive cocci, erm-mediated macrolide resistance in pneumococci, extended-spectrum beta-lactamases (ESBLs) in Enterobacteriaceae and Pseudomonas aeruginosa, and acquired penicillinases in Enterobacteriaceae. VanA, VanB and VanC phenotypes of enterococci were distinguished reliably, and ESBL production was accurately inferred in AmpC-inducible species as well as Escherichia coli and Klebsiella spp. Mechanisms identified, but only as possibilities among several, included IRT-type beta-lactamases and individual aminoglycoside-modifying enzymes in Enterobacteriaceae. Most disagreements with reference data concerned pneumococci found to have high-level penicillin resistance by the VITEK 2 AES but previously determined, phenotypically, to have intermediate resistance. When ESBL production was inferred in E. coli and klebsiellae, the VITEK 2 AES edited susceptible results for cephalosporins (except cefoxitin) to resistant; when an acquired penicillinase was inferred in Enterobacteriaceae, piperacillin results were edited to resistant; and when staphylococci were found methicillin resistant, resistance was reported for all beta-lactams. Further editing may be desirable (e.g. of cephalosporin results for salmonellas inferred to have ESBLs).
Keywords
Data Interpretation, Statistical, Drug Resistance, Multiple, Bacterial/genetics, Humans, Microbial Sensitivity Tests/instrumentation, Microbial Sensitivity Tests/methods
Pubmed
Web of science
Open Access
Yes
Create date
11/02/2008 13:40
Last modification date
25/09/2019 7:11
Usage data