论文部分内容阅读
目的评估Carba NP试验(CNPt)及碳青霉烯类失活(CIM)试验在碳青霉烯类耐药肠杆菌科细菌中检测碳青霉烯酶的性能及临床价值。方法收集南京医科大学附属无锡市第二人民医院2014—2015年临床分离的各种标本碳青霉烯类耐药肠杆菌科细菌菌株92株,同时选取碳青霉烯敏感的菌株90株作为对照组。所有菌株进行碳青霉烯酶耐药基因PCR检测、碳青霉烯类失活(CIM)试验、CNPt、改良Hodge试验(MHT)检测。结果 92株碳青霉烯类耐药肠杆菌科细菌包括产碳青霉烯酶肠杆菌87株及非产碳青霉烯酶肠杆菌5株;87株产酶株中79株产A组酶;8株产B组酶,未检测到D组的碳青霉烯酶。CNPt与CIM试验诊断菌株是否产碳青霉烯酶的敏感性和特异性均为100%;MHT实验诊断菌株是否产碳青霉烯酶敏感性为96.5%,特异性为98.9%。结论 CNPt及CIM试验能快速、准确筛查出临床分离鉴定的产碳青霉烯酶的肠杆菌科细菌,在常规的微生物实验室有发展前景,可作为表型确认试验和耐药监测的手段。
Objective To evaluate the efficacy and clinical value of the Carba NP test (CNPt) and the carbapenem-based inactivation (CIM) test for detecting carbapenemases in carbapenem-resistant enterobacteriaceae. Methods Ninety-two strains of carbapenem-resistant Enterobacteriaceae isolates were collected from No.2 People’s Hospital of Wuxi Medical University from 2014 to 2015. Ninety-eight strains of carbapenem-sensitive strains were selected as controls group. All strains were tested for carbapenemase resistance gene PCR, carbapenem inactivation (CIM) test, CNPt, modified Hodge test (MHT). Results Ninety-two carbapenem-resistant enterobacteriaceae strains included 87 carbapenema-producing Enterobacteriaceae strains and 5 non-carbapenemase Enterobacter strains. Of the 87 strains, 79 were Group A enzymes ; 8 strains produced B group enzyme, did not detect C group carbapenemase. The susceptibility and specificity of carbapenemase produced by CNPt and CIM test strains were all 100%. The sensitivity and specificity of MHT test for isolates of carbapenemase were 96.5% and 98.9% respectively. Conclusion The CNPt and CIM tests can rapidly and accurately screen out Enterobacteriaceae producing carbapenemase isolated and identified clinically and have the prospect of development in routine microbiology laboratory and can be used as a means to confirm phenotype test and drug resistance monitoring .