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2003, Cilt 17, Sayı 3, Sayfa(lar) 301-306
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OTOMATİZE KAN KÜLTÜRLERİNDE ÜREYEN BAKTERİLER İÇİN DİREKT VE STANDART DİSK DİFÜZYON TESTLERİNİN DEĞERLENDİRİLMESİ
İdris ŞAHİN1, İrfan ŞENCAN2, Demet KAYA1, Şükrü ÖKSÜZ1, Aynur GÜLCAN1
1Düzce Faculty of Medicine, Abant Izzet Baysal University, Department of Microbiology and Clinical Microbiology, Düzce
2Düzce Faculty of Medicine, Abant Izzet Baysal University, Department of Clinical Microbiology and Infectious Diseases, Düzce
Keywords: Automated blood cultures, bacteria, direct antimicrobial susceptibility testing, standard antimicrobial susceptibility testing, disk diffusion method

The aim of this study is to evaluate direct and standardized antimicrobial susceptibility testing methods for the detection of bacteria isolated from automated blood cultures. In accordance with the protocol of the study, 126 blood cultures were collected from the patients during a 12-month period in 2001-2002. The samples from positive bottles showing growth of Gram-negative bacilli or clustered Gram-positive cocci, determined by Gram staining, were used for direct inoculation onto Mueller Hinton agar. The negative smears which had positive cultures and the positive smears which showed mixed cultures were excluded from the study. The results of direct disk diffusion tests were compared with those of standard Kirby-Bauer disk diffusion method, and discrepancies were classified as very major, major, or minor errors. The overall agreement of the two methods for Staphylococcus aureus and coagulase-negative staphylococci, in terms of the interpretive categories (susceptible, intermediate, and resistant) were 92.2 % and 90.7%, respectively. There were 32 (2.5%) very major errors, 16 (1.3%) major errors and eight (0.6%) minor errors which were caused by the direct method for Staphylococus spp. The overall agreement of the two methods for Enterobacteriaceae and Pseudomonas spp. in terms of the interpretive categories were 92.1% and 96.8%, respectively. There were 22 (1.5%) very major errors, 11 (0.7%) major errors and 19 (1.3%) minor errors caused by direct method for Gram-negative bacilli. The rapid method for the antimicrobial susceptibility testing of Gram-negative bacilli and oxacilline resistant S. aureus is simple and requires no centrifugation, preincubation, or standardization of the inocula. This method can be used for patients with bacteremia. The direct disk method is proposed as a test that can be used as a supplement to the standardized procedures for the earlier determination of the susceptibility patterns of aerobic Gram-negative bacilli and Staphylococcus spp. from blood cultures.

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