ラピッドルミ®`栄研`のリアルタイム送信を中心とした 薬剤感受性検査
Contents
1. 1 2 KB 9 Vitek120 26 3782. IA JR RR REER A amp T R 1 National Committee for Clinical Laboratory Standards Performance standards for antimicrobial susceptibility testing Supplement tables M100 S11 Wayne Pa NCCLS 2001 MIA 1998 VITEK 47 1231 1235 1998 VITEK45 wells 47 152 157 4 2001 Pseudomonas ge72g220s57 1 5 BA D 1998
3. MIC BACTSYSTEM 5 13 4 16 14 10 Acinetobacter Viteck 76 Vol13 No 2 2003
4. SRF T 420 8630 10 93 TEL 054 253 3125 2407 FAX 054 252 0010 IF BACTSYSTEM KB Rw ROME KB BACTSYSTEM A VitekW120 IF Vitek
5. 1 2 1 Off GNR Oxidase ZUZ5 P aeruginosa Oxidase ZUZ1 P mirabilis BR lt S maltophilia GPC Catalase ZUZ2 Genus Staphylococcus Catalase ZUZ2 Genus Enterococcus 70 VoL13 No 2 2003 709 3 b 5S pneumoniae Haemophilus 3 KB 2 LADJ B MIC S pneumoniae Haemophilus
6. VITEK MINO EM CP MINO ST MRSA MPIPC VCM TEIC IS60 Lucy2 4 BACTSYSTEM Vitek Vitek 4 Vitek 4 GNI 76 8 GPI 94 2
7. MRSA MIC IPM MINO 83 ST 97 MRSA MPIPC 100 MIC EM MINO CP LVFX CTX ABK ST MSSA MIC MPIPC PCG CTX EM ST 95 ST 100 Vol13 No 2 2003 13 112 5 5 1 GNR 76 ABPC PIPC CEZ CTM CMZ CZX CAZ FMOX SBT CPZ IPM GM AMK MINO AZT FOM LVFX ST MIC 76 89 97 86 95 91 93 93 97 88 97 80 76 97 83 100 99 86 99 99 95 100 100 100 95 100 100 99 97 99 99 83 100 99 5 2 P aeruginosa 35 PIPC CAZ CFPM CZOP CFSL SBT CPZ IPM GM AMK TOB ABK MINO AZT FOM LVFX CPFX MIC 54 91 83 86 74 97 83 83 91 100 97 89 7
8. epitopes BELOT IPM Meropenem MEPM TIPM sien Ck oTHER filament Ee SAAT MEPM filament bulge form pe raceme 9 MEPM MIC MEPM MINO RRR LYLO GNR MRSA Enterococcus MINO GNR MINO
9. Pseudomonas aeruginosa Gram Negative Rods GNR 705 P aeruginosa 75 5 Staphylococcus aureus 73 7 methicillin resistant Staphylococcus aureus MRSA 95 9 coagulase negative Staphylococcus CNS 69 4 Enterococcus 70 6 76 0 219 288 Key words 18 Fil
10. KB 3 BACTSYSTEM 4 C LINILAN MBSA amp T 5 Doctor XSBS 3 4 5 2 HAN RR SEVERED EH OT SR AL 1 1 WEL Proteus mirabilis P mirabilis LTR CHS OF FU HIRST NF GNR Pseudomonas aeruginosa Stenotrophomona maltophilia 2 WFE Acinetobacter spp Alcaligenes spp Burkholderia cepacia Burkholderia putida Fla vobacterium SDD NF GNR Staphylococcus Ent erococcus Streptococcus pneumoniae Haemophilus
11. Acinetobacter GNR K IPM CPE SR TRIB Ow clk TIPM IPM D AAC PE ANT RAS A O 24 oe oo BIE AB PE Uk 7 5 Yo C SRY IPM 1 IPM 2 53 21 IPM 1PM RK ei ge et ni
12. 8 206 210 ANGE 1998 25 387 392 7 1998 VITEK 45wells JARMAM 9 55 58 2001 11 98 103 2 3 6 8 Vol 13 No 2 2003 17 FAS AS i AE ys 776 18 A computer assisted on line system interfaced with a microbiology instrument Rapid Lumi Eiken for real time reporting of the results of antimicrobial susceptibility test Naoki Sugimoto Mika Endo Department of Clinical Laboratory Shizuoka City Hospital In April 2001 we began using the Rapid Lumi Eiken Chemical system which provides antimicrobial susceptibility test results within 4 hours and started real time transmission of the Rapid Lumi results to the hospital s medical care information system under the BACTSYSTEM transmission control procedures accuracy control check for drug
13. IS60 BACT A amp T TF Tavs GNR 95 12 6 3 6 16 3 29 5 70 5 16 8 83 2 12 95 3 83 13 80 28 95 67 95 16 95 79 95 P aeruginosa 53 24 5 0 0 0 0 24 5 75 5 5 7 94 3 13 53 0 40 0 40 13 53 40 53 3 53 50 53 GNR 148 16 9 2 4 10 8 27 7 72 3 12 8 87 2 25 148 3 123 13 120 41 148 107 148 19 148 129 148 MSSA 38 26 3 0 0 0 0 26 3 73 7 5 3 94 7 10 38 0 28 0 28 10 38 28 38 2 38 36 38 MRSA 49 4 1 0 0 0 0 4 1 95 9 0 0 100 0 2 49 0 47 0 47 2 49 47 49 0 49 49 49 CNS 36 13 9 19 4 0 0 30 6 69 4 9 4 80 6 5 36 6 31 0 25 11 36 25 36 7 36 29 36 Genus Enterococcus 17 17 6 14 3 0 0 29 4 70 6 1 8 88 2 3 17 2 14 0 12 5 17 12 17 2 17 15 17 GPC 140 14 3 6 7 0 0 20 0 80 0 7 9 92 1 20 140 8 120 0 112 28 140 112 140 11 140 129 140 288 15 6 3 8 4 5 24 0 76 0 0 4 89 6 45 288 11 288 13 288 69 288 219 288 30 288 258 288 GNR P mirabilis S maltophilia k U Acinetobacter spp IS60 IS60 Lucy2 BACTSYSTEM
14. MRSA Vitek Vitek 24 IA20 BACTSYSTEM 4 BACTSYSTEM BACTSYSTEM 3 4 C
15. 4 Vitek 4 GNI 76 8 73 95 GPI 94 2 16 17 3 BACTSYSTEM NCCLS Vol13 No 2 2003 15 114 BACTSYSTEM KB i
16. A amp T BACTSYSTEM Vitek Ey PVs OFM ig 6
17. CNS MIC PCG ABPC CTX IPM ABK ST CP 84 AMK ST 96 MIC EM MINO CP FOM CEZ GM AMK ABK ST MPIPC 1 Enterococcus MIC EM MINO CP 94 MINO 94 MIC MINO LVFX 2 6 14 Vol 13 No 2 2003 bb IS60 IS60 Lucy2 BACTSYSTEM BACT 1S60 Lucy2 BACTSYSTEM
18. 3 2 coagulase negative Staphylococcus CNS P aeruginosa BACTSYSTEM IS60 Lucy2 TIS60 Lucy2 i Sx noe 1 i ime SS PE RETA BARE A0 2 EAP BACTSYSTEM aint Hy ERP yao EEA rA E IFF d h ris Fai Mr E La IS60 Lucy2 Vitek IS60 Lucy2 4 BACTSYSTEM FISHER MNZ CNS P aeruginosa Vitek HEW NCCLS BACTSYSTEM HEE Vitek FEMA Ch
19. 200 Escherichia coli 11 E coli ESBL 2 Enterobacter aerogenes 7 Enterobacter cloacae 10 Enterobacter spp 1 Citrobacter spp 3 tk Klebsiella pneumoniae 10 Morganella morganii 2 Serratia marcescens 10 Serratia liquefaciens 1 Salmonella Typhi 6 Salmonella ParatyphiA 2 tk Shigella so nnei 1 Salmonella sp serogroup O7 2 Yersinia enterocolitica 1 Providencia rettgeri 2 Proteus vulgaris 1 S maltophilia 3 TOMO BAMA 1 P aeruginosa 35 Staphylococcus aureus MS SA 19 S aureus MRSA 29 CNS 25 MPI PC 23 2 Enterococcus faecalis 12 Enterococcus faecium 2 Enterococcus avium 1 Enterococcus spp 1 FE MIC S L R WRAL PO amp BY TA Oxacilin MPIPC Benzylpenicillin PCG Ampicilin ABPC Piper acillin PIPC Cefazolin CEZ Cefotiam CTM Cefmetazole CMZ Cefotaxime CTX Ceftizoxime CZX Ceftazidime CAZ Cefepime CFPM Cefozopran CZOP Cefoselis CFSL Flomoxef FMOX Sulbactam Cefoperazone SBT CPZ Imipenem IPM Gentamicin GM Amikacin A MK Tobramycin TOB Arbekacin ABK Mi nocycline
20. RH 14 9 17 15 7 2 13 4 4 ROP BACTSYSTEM RW KB ROP D BACTSYSTEM 3 13 8 28 9 27 288
21. BACT Fa y 7 BACTSYSTEM A amp T 76 0 219 288 F 89 69 258 288 A amp T GNR 13 12 4 baumannii P aeruginosa Cla IS60 Lucy2
22. MIC I A VolL13 No 2 2003 9 108 m a F gm Erp e iE a E EThiaral RE AC ee bhi mt hit PATA ie IA20 RF RE ey AE z AAT HERAA BACTSYSTEM sent es ae Witek 120 R220 IS 6 0 Lucy2 Sey FILE SH ME KB RET 1 Bo 600 1 600 1 100 1 14 6 000 4 B 1 1 1 Vitek 2 IS60 Lucy2 IA20
23. STOP E faecium 4 VRSA TRORA MRSAHE VCM gt 2 STOP S aureus MRSA S aureus 5 ABPC S marcescens ABPC S MIC ABPC K pneumoniae R 6 CEZ S marcescens CEZ S DA MIC CEZ R 7 CTM S marcescens CTM S DO MIC CTM R 8 MINO I gt R MINO D MEX MIC MINO JE R 9 MINOO MINO 4 S MIC MINO IH R 10 2 22 RRA IPM POS C R POCAZROLE RUST D BEV IPM R S C R CAZ R 11 AKIRA CAZ S CFPM S IPM S IPM MIC
24. 13 11 2 75 5 11 10 94 3 MSSA 1S60 Lucy2 10 8 MRSA 95 9 100 CNS IS60 Lucy2 5 1 BACTSYSTEM 6 Staphylococcus VCM gt 2 g ml 3 Enterococcus TS60 Lucy2 3 2 BACTSYSTEM 2 1 EnterococcusD VCM gt 1 u g ml 1 Vitek
25. IPM IPM IPM GM S AZT S 12 MRSA 7 FSR MRSA 4 MPIPC gt 2 R S aureus R MRSA 13 MSSA 7 BSR MRSA HEP MPIPC lt 2 S 22 POG S aureus R ABPC R CER Morganella morganii 2 GNR Enterobacteriaceae 2 S maltophilia 5 Acinetobacter baumannii 12 P aeruginosa 53 MSSA 38 MRSA 49 CNS 36 Enterococcus 17 I R 1 5 GNR MIC ABPC MINO 80 ABPC CTM 95 WM K pneumoniae D ABPC B amp U S marcescens ABPC CTM aeruginosa MIC PIPC CFSL AZT 80 MINO FOM 97 MIC PIPC CAZ CFPM CZOP CFSL MINO AZT
26. B 200 Vitek 23 BACTSYSTEM K pneumoniae S marcescens Cli ABPC R S IS60 Lucy2 ABPC S BACTSYSTEM MIC R NN
27. MINO Erythromycin EM Clindamycin CLDM Vancomycin VCM Teicoplanin TEIC Aztreonam AZT Fosfomycin FOM Levofloxacin LVFX Ciprofloxacin CPFX Sulfamethoxazole Trimethoprim ST Chloramphenicol CP 4R MIC 1 minor error D 13 8 28 9 27 288 coli 20 K pneumoniae 21 k S marcescens 11 E cloacae 13 E aerogenes 4 Enterobacter spp 2 Citrobacter spp 3 3 BACTSYSTEM HERA KB 1 5 M
28. resistance strains of bacteria In order to rationally implement antimicrobial susceptibility testing for common clinical isolates it was deemed necessary to consider the Dry Plate Eiken Chemical method of dilution antimicrobial susceptibility testing and the KB Disk Eiken Chemical antimicrobial disk susceptibility test in addition to the quick result Rapid Lumi system This allowed us to build an antimicrobial susceptibility testing system that consolidates 3 testing methods with transmission controlled by BACTSYSTEM together with the Rapid Lumi system To evaluate the system s transmission of the Rapid Lumi results our hospital examined the transmitted results over a period of 1 month Aug 28 to Sep 27 2001 for 288 strains of clinical isolates Results Gram negative rods excluding Pseudomonas aeruginosa 70 5 P aeruginosa 75 5 Stapylococcus aureus 73 7 methicillin resistant Staphylococcus aureus MRSA 95 9 coagulase negative Staphylococcus CNS 69 4 Genus Enterococcus 70 6 total 76 0 219 288 strains These results indicate that the real time transmission system utilizing Rapid Lumi is useful in meeting the need to quickly obtain clinical test results VoL13 No 2 2003 gt gt
29. 4 80 100 100 100 97 100 100 100 97 97 100 97 100 97 89 100 80 100 100 5 3 S aureus MRSA 29 MPIPC PCG ABPC CEZ CTM CTX IPM GM AMK ABK VCM TEIC EM CLDM MINO FOM LVFX ST GP MIC 100 93 86 90 83 97 76 100 100 90 00 83 90 00 72 90 97 93 97 aAFIY HE 100 100 100 97 100 97 97 100 100 100 00 100 100 00 97 97 00 72 100 325 4 S aureus MSSA 19 MPIPC PCG ABPC CEZ CTM CTX IPM GM AMK ABK VCM TEIC EM CLDM MINO FOM LVFX ST CP MIC 63 84 95 100 100 68 100 95 100 100 00 100 84 00 100 100 00 68 95 100 100 100 100 100 100 100 100 100 100 00 100 100 00 100 100 00 68 100 5 5 CNS 25 MPIPC PCG ABPC CEZ CTM CTX IPM GM AMK ABK VCM TEIC EM CLDM MINO FOM LVFX ST CP MIC 84 76 64 84 92 76 72 92 72 00 84 88 00 96 88 00 60 76 96 100 96 96 96 96 96 100 100 00 100 100 00 100 96 00 60 96 5 6 Enterococcus sp 16 PCG ABPC IPM VCM TEIC EM MNO LVFX MIC 100 100 94 100 100 75 75 94 AFAY HE 100 100 94 100 100 100 88 94 100 MPIPC MIC 63 100 MRSA MIC PCG ABPC CTX GM EM CP ST
30. B SNS COB BACTSYSTEM Vitek Vitek BACTSYSTEM Vitek Vitek Vitek 120 s Hemne UP et IS 6 0 Lucy2 KB 2 REAA CMT 4 ME w H GNR Oxidase test Vitek GNI DER GNR Oxidase test Vitek GNI P aeruginosa NF GNR GPC Catalase test Coagulase test GEENA MRSA Coagulase test CNS Catalase test Vitek GPI Hes a PERA HER 7 BERR MRSA MRSA BACTSYSTEM Vol13 No 2 2003 7 770
31. IC And Or ESBLs 1 72 Vol13 No 2 2003 777 4 BACTSYSTEM No Wf 1 NMA CEZ S 3 1 R STOP Staphylococcus CEZ R CTM S CTX S MPIPC 5 MRSA ABPC S PIPC R ABPC S PIPC R 2 S maltophilia S maltophilia MINO L R STOP 3 VRE E faecalis VCM gt 1
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