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目的评估Carba NP试验检测多重耐药革兰阴性杆菌产碳青霉烯酶的效果。方法收集我院2010-2013年59株多重耐药革兰阴性杆菌,采用VITEK-2全自动细菌鉴定药敏系统进行种属鉴定并检测菌株对碳青霉烯类药物的敏感性,用Carba NP试验检测菌株产碳青霉烯酶表型,用PCR法确定碳青霉烯酶基因型,并对PCR产物进行DNA测序分析。结果 59株多重耐药革兰阴性杆菌对亚胺培南、美洛培南、厄他培南耐药率分别为62.71%、61.02%和64.41%。Carba NP试验确定33株产碳青霉烯酶菌株,分别为A类酶12株、B类酶21株,PCR法检出多种碳青霉烯酶基因,包括KPC(12株)、IMP(7株)、NDM(12株)、VIM(3株)。与PCR法比较,Carba NP试验敏感性和特异性分别为97.06%、100%。结论 Carba NP试验能简单快速地检测多重耐药革兰阴性杆菌产生的碳青霉烯酶,结果与金标准的PCR法有高度一致性,值得在临床检验中推广使用。
Objective To evaluate the efficacy of Carba NP assay for the detection of carbapenemases in multi-drug resistant Gram-negative bacilli. Methods 59 multidrug-resistant Gram-negative bacilli collected in our hospital from 2010 to 2013 were collected. The species was identified by VITEK-2 automatic bacterial identification system and the susceptibility of the strains to carbapenems was tested. Carba NP The strain was tested for carbapenemase phenotype, the PCR method was used to determine the carbapenemase genotype, and the PCR products were subjected to DNA sequencing. Results The resistance rates of 59 multidrug-resistant Gram-negative bacilli to imipenem, meropenem and ertapenem were 62.71%, 61.02% and 64.41%, respectively. Carba NP test determined that 33 strains of carbapenemase were 12 strains of class A and 21 of class B, respectively. A variety of carbapenemase genes were detected by PCR including KPC (12 strains), IMP ( 7), NDM (12), VIM (3). Compared with the PCR method, Carba NP test sensitivity and specificity were 97.06%, 100%. Conclusion Carba NP test can detect carbapenemases produced by multi-resistant Gram-negative bacilli in a simple and rapid way. The results are in good agreement with the gold standard PCR method, which is worth to be used in clinic.