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Utvärdering av direktresistensmetod på urinodlingar gentemot EUCAST diskdiffusionsmetod
Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
2019 (Swedish)Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
Abstract [sv]

Urinvägsinfektioner är den näst vanligaste anledningen till antibiotikaförskrivning i Sverige. För diagnos av UVI i urinkultur med standardmetoden krävs 18 - 48 timmar och ytterligare 24 timmar i odling tills resultaten för antimikrobiell känslighetstestning är tillgängliga. Direktresistensmetoden ger svar 24 timmar tidigare än standardmetoden. Studiens syfte var att utvärdera direktresistensmetoden (in-housemetod) från mikrobiologiska laboratoriet Unilabs, Skövde på urinodlingar från patientprover och jämföra den med EUCAST-diskdiffusionsmetod. I denna studie användes 334 bakteriestammar från urinodlingar; E. coli (n=211) E. faecalis (n=45), Klebsiella spp (n=37), P. mirabilis (n= 17) och övriga gramnegativa bakteriestammar (n=24). Direktresistensmetoden och EUCAST diskdiffusionsmetod har utförts parallellt på alla bakteriestammar och sex olika antibiotikatyper testades. Hämningszonernas diameter lästes av och placerades i rätt S, I, R kategori för respektive antibiotikum. Från sammanlagt 1674 testade antibiotikalappar hittades 23 avvikelser där E. coli representerade 13 av dessa. Mecillinam var det antibiotikum där flest avvikelser noterades, totalt tio stycken. Överensstämmelsen mellan de två metoderna var 98,6% från 1674 testade antibiotikalappar. Direktresistensmetoden leder till att patienten få ett svar 24 timmar tidigare än med EUCAST diskdiffusionsmetoden där svaret inkluderar även resistensbestämning.

Abstract [en]

Urinary tract infections are the second most common reason for prescription of antibiotics in Sweden. Diagnosis of UTIs in urine culture by the standard method requires 18 to 48 hours and an additional 24 hours until antimicrobial testing is available. The direct resistance method provides answers 24 hours earlier than the standard method. The aim of the study was to evaluate the direct resistance method (in-house method) from the microbiological laboratory Unilabs, Skövde on urine cultures from patient samples and compare it with the EUCAST disc diffusion method. For this study, 334 bacterial strains from urinary cultures were used; E. coli (n = 211) E. faecalis (n = 45), Klebsiella spp (n = 37), P. mirabilis (n = 17) and other gram-negative rods (n = 24). The direct resistance method and the EUCAST disk diffusion method were performed in parallel on all bacterial strains and six different types of antibiotics were tested. The diameter of the inhibition zones was measured and categorized according to S, I, R for each antibiotic. From a total of 1674 tested antibiotics 23 discrepancies were found where E. coli represented 13 of these. Mecillinam was the antibiotic where most discrepancies were noted, a total of ten. The agreement between the two methods was 98,6% from 1674 tested antibiotics. The direct resistance method allows a response to the patient 24 hours earlier than the EUCAST disc diffusion method.

Place, publisher, year, edition, pages
2019. , p. 20
Keywords [en]
urinary tract infections, E. coli, mecillinam, very major errors, antibiotic resistance
Keywords [sv]
urinvägsinfektion, E. coli, mecillinam, very major errors, antibiotikaresistens
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-45142ISRN: JU-HHJ-BLA-1-20190089OAI: oai:DiVA.org:hj-45142DiVA, id: diva2:1331508
Subject / course
HHJ, Biomedical Laboratory Science
Presentation
2019-06-04, HHJ (Ga1031), Jönköping University Gjuterigatan 5, Jönköping, 09:30 (Swedish)
Supervisors
Examiners
Available from: 2019-06-28 Created: 2019-06-26 Last updated: 2019-06-28Bibliographically approved

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