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Uh, Jang, Lee, Kwon, and Yoon: Comparison of the MicroScanⓇ Combo Panel Synergies plus with the MicroScanⓇ Conventional Combo Panel for Diagnostic Performance of Gram-negative and Gram-positive Bacteria
Original Article

Korean J Clin Microbiol 2009;12(4):193-200.

Published online: 22 December 2009

DOI: https://doi.org/10.5145/KJCM.2009.12.4.193

Comparison of the MicroScanⓇ Combo Panel Synergies plus with the MicroScanⓇ Conventional Combo Panel for Diagnostic Performance of Gram-negative and Gram-positive Bacteria

Young Uh, In Ho Jang, Kwan Soo Lee, Ohgun Kwon, Kap Jun Yoon

Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea

Correspondence: Young Uh, Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, 162, Ilsan-dong, Wonju 220-701, Korea. (Tel) 82-33-741-1592, (Fax) 82-33-731-0506, (E-mail) u931018@yonsei.ac.kr

Received 30 July 20097 September 2009       Accepted 15 October 2009

Copyright © 2009 Korean Journal of Clinical Microbiology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

To access the clinical usefulness of MicroScanⓇ Synergies plus Combo Panels (Siemens, USA) for the identification and antimicrobial susceptibility test (AST) of Gram-negative bacteria (GNB) and Gram-positive cocci (GPC), we compared MicroScanⓇ Synergies plus Combo Panels with MicroScanⓇ conventional Combo Panels.

Methods

One-hundred four isolates of GNB were simultaneously tested with MicroScanⓇ Synergies plus Neg Combo Type 2 Panel (SINC2) and MicroScanⓇ Neg Combo Panel Type 44 (NC44). One-hundred isolates of GPC were simultaneously tested with MicroScanⓇ Synergies plus Pos Combo 3 Panel (SIPC3) and MicroScanⓇ Pos Combo 1A (PC1A).

Results

Of the GNB isolates, agreement rate of identification between SINC2 and NC44 were 92.3% to the species level and 93.3% to the genus level. Of the GPC isolates, agreement rate of identification between SIPC3 and PC1A were 85.0% to the species level and 100% to the genus level. Of the GNB isolates, agreement rate of AST according to antimicrobial agents between SINC2 and NC44 ranged from 86.5% to 100%. Among GPC isolates, agreement rate of AST according to antimicrobial agents between SIPC3 and PC1A were higher than 96.0% with the exception of gentamicin and quinupristin-dalfopristin.

Conclusion

Compared with MicroScanⓇ conventional Combo Panels (NC44, PC1A), MicroScanⓇ Synergies plus Combo Panels (SINC2, SIPC3) showed high agreement rate of identification and AST, and had the advantage of more rapid reporting.

Keywords: MicroScanⓇ, Identification, Antimicrobial susceptibility test

REFERENCES

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Table 1.
Comparison of gram-negative bacilli identification results between MicroScan Synergies plus® Neg Combo Type 2 Panel (SINC2) and MicroScan Neg Combo Panel Type 44 (NC44)
ID by SINC2 ID by NC44
Non-fermenter Fermenter
ABA ALO AXY BCE CME MOR PAE RPI SPA XMA CFR EAE ECL ECO KOX KPN LAD MMM PMI PAL PRE PST SAL SLI SMA VPA YPS
ABA 9                                                    
ALO                                                      
AXY     2               1∗                                
BCE       3                                              
CME         2                                            
MOR   1†                                                  
PAE             7                                        
RPI                                                      
SPA         1§       1                                    
XMA                   5                                  
CFR                               1|||                      
EAE                       2                              
ECL                         5                            
ECO                           17                          
KOX                             1 1∗∗                      
KPN                               21                      
LAD                                 1                    
MMM     1††                               5                
PMI                                     3                
PAL                                       1              
PRE                                         2            
PST                                           2          
SAL                                             2        
SLI SMA                                               1 2    
VPA                                                   1  
YPS                                                     1

∗ Final identification: A. xylosoxidans; † Final identification: A. Iwoffii:; † Final identification: P. aeruginosa; §Final identification: S. paucimobilis; ||Final identification: K. pneumoniae: ∗Final identification: Citrobacter freundii: ∗∗Final identification: K. pneumoniae, ^ Final identification: P. rettgeri.

Abbreviations: ABA, Acinetobacter baumannii/haemolyticus; ALO, Acinetobacter Iwoffii: AXY, Achromobacter xylosoxidans subsp. xylosoxidans; BCE, Burkholderia cepacia; CFR, Citrobacter freundii complex; CME, Chryseobacterium meningosepticum; EAE, Enterobacter aerogenes; ECL, Enterobacter cloacae; ECO, Escherichia coli; KOX, Klebsiella oxytoca; KPN, Klebsiella pneumoniae subsp. pneumoniae; LAD, Leclercia adecarboxylata; MMM, Morganella morganii subsp. morganii; MOR, Moraxella spQCÌQs/Psychrobacter species; PAE, Pseudomonas aeruginosa; RPI, Ralstonia pickettii; SPA, Sphingomonas paucimobilis; XMA, Stenotrophomonas maltophilia; PMI, Proteus mirabilis; PAL, Providencia alcalifaciens; PRE, Providencia rettgeri; PST, Providencia stuardi; SAL, Salmonella species; SLI, Serratia liquefaciens; SMA, Serratia marcescens; VPA, parahaemolyticus/alginolyticus; YPS, Yersinia pseudotuberculosis.

Table 2.
Comparison of gram-positive cocci identification results between MicroScan Synergies plus® Pos Combo 3 Panel (SIPC3) and MicroScan Pos Combo 1A (PCIA)
ID by SIPC3 ID by PCI A
Staphylococcus Streptococcus Enterococcus
SAU SAR SCA SCO SEP SHE SHO SSI SWA SCN SMI SPN EAV EFA EFM ENT
SAU 25     1                        
SAR     1                          
SCA     3                          
SCO     1∗                          
SEP     3 25   1                    
SHE         6                      
SHO           8†                    
SSI             1                  
SWA           1                    
SCN     3† 1                        
SMI                   1            
SPN                   1            
EAV                       1        
EFA                         8      
EFM                           6    
ENT                           3    

∗ S. cohnii subsp. urealyticum by PCI A; †One isolate was S. hominis subsp. novobiosepticus by PCI A: ‡Two isolates were S. capitis subspecies ureolyticus and one isolate was S. capitis subsp. capitis by PCI A.

Abbreviations: SAU, Staphylococcus aureus; SAR, Staphylococcus auricularis; SCA, Staphylococcus capitis; BCE, Staphylococcus cohnii; SEP, Staphylococcus epidermidis; SHE, Staphylococcus haemolyticus; SHO, Staphylococcus hominis; SSI, Staphylococcus simulans; SWA, Staphylococcus warneri; SCN, coagulase-negative staphylococci; SMI, Streptococcus mitis/oralis; SPN, Streptococcus pneumoniae; EAV, Enterococcus avium; EFA, Enterococcus faecal is·, EFM, Enterococcus faecium; ENT, Enterococcus species.

Table 3.
Comparison of gram-negative bacilli antimicrobial susceptiblity results by CLSI interpretive criteria for β -lactams between MicroScan Synergies plus® Neg Combo Type 2 Panel (SINC2) and MicroScan Neg Combo Panel Type 44 (NC44)
SINC2 NC44
AMP AMS TIM PPT CFZ CFX CTT CAZ CRO FEP ATM IPM MEM
S I R S I R S I R S I R S I R S I R S I R S I R S I R S I R S I R S I R S I R
S 11 5   23 2   58 3 1 66 3   29 2 1 34   1 54   4 71 2 1 57 2 1 68     61   3 77 3 1 82    
I   1   1 3   5 8 5 3 1           1 1   1 2   4 2   3     5     4 1   1 6   2 1
R   1 55 2 1 24     24 2   11     40 1 4 27 2   5 1 1 22 1   31     26 3   17     8   1 13
MaE (%)   0     3.6     1.0     2.3     1.4     2.9     8.8     1.9     2.1     0     6.7     1.0     0  
MiE (%)   8.2     7.1     12.5     7.0     2.8     7.2     3.0     4.8     2.1     0     1.2     9.4     2.0 !
CA (%)   91.8     89.3     86.5     90.7     95.8     89.9     88.2     93.3     95.8     100     92.1     89.6     98.0 1

Abbreviations: AMP, ampicillin; AMS, ampicillin/sulbactam; TIM, ticarcillin/clavulanic acid; PPT, piperacillin/tazobactam; CFZ, cefazolin; CFX, cefuroxime; CTT, cefotetan; CAZ, ceftazidime; CRO, ceftriaxone; FEP, cefepime; ATM, aztreonam; IPM, imipenem; MEM, meropenem; S, susceptible; I, intermediate; R, resistant; MaE, major error; MiE, minor error; CA, complete agreement.

Table 4.
Comparison of gram-negative bacilli antimicrobial susceptiblity results for non- β -lactams between MicroScan Synergies plus Neg Combo Type 2 Panel (SINC2) and MicroScan Neg Combo Panel Type 44 (NC44)
NC44 SINC2
AMK GEN TOB CIP LEV SXT
S I R S I R S I R S I R S I R S I R
S 64 3 1 55 1   55 3   51 2   65 1   59   2
I     1   1 1     8 2 3 3   3 10      
R 1   24   1 35     28     35     25 1   34
MaE (%)   2.1     0     0     0     0     3.1  
MiE (%)   4.3     3.2     11.7     7.3     10.6     0  
CA (%)   93.6     96.8     88.3     92.7     89.4     96.9  

Abbreviations: AMK, amikacin; GEN, gentamicin; TOB, tobramycin; CIP, ciprofloxacin; LEV, levofloxacin; SXT, sulfamethoxazole/trimethoprim. Other abbreviations: see Table 3.

Table 5.
Comparison of gram-positive cocci’s antimicrobial susceptiblity results by CLSI interpretive criteria between MicroScan Synergies plus® Pos Combo 3 Panel (SIPC3) and MicroScan Pos Combo 1A (PCIA)
SIPC3 PC1A
Staphylococcus (Enterococcus)
PEN OXA VAN CLI ERY GEN RIF SYN TET SXT AMP GMS SMS
S I R S I R S I R S I R S I R S I R S I R S I R S I R S I R S I R S I R S I R
S 1     1     74 1   39 1 1 31     16 3 2 64   2 72 3   41     54   1                  
I                             1     6 1                                        
R 1   75 2   74       1   33 1   42     48     8           34 2   18                  
S (8)∗   (1)       (16)                             (4)   (2) (10)           (8)     (10)     (11)    
I                                                                              
R     (9)           (2)                                 (2) (6)           (V)     (8)     (V)
MaE (%)   2.1     2.6     0     2.7     1.3     2.7     2.7     2.5     0     4.0     0     0     0  
MiE (%)   0     0     1.1     1.3     1.3     12.0     1.3     3.7     2.2     0     0     0     0  
CA (%)   97.9     97.4     98.9     96.0     97.4     85.3     96.0     93.8     97.8     96.0     100     100     100  

∗ Numbers in parenthesis means enterococcal isolates.

Abbreviations: PEN, penicillin; OXA, oxacillin; VAN, vancomycin; CLI, clindamycin; ERY, erythromycin; GEN, gentamicin; RIF, refampin; SYN, quinupristin-dalfopristin; TET, tetracycline; GMS, gentamicin synergy; SMS, streptomycin synergy; S, susceptible; I, intermediate; R, resistant.

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