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目的评价ChromID ESBL选择性显色平板对产超广谱β-内酰胺酶(ESBLs)肠杆菌科细菌的筛选效果。方法选取临床分离的371株肠杆菌科细菌进行ESBLs的检测,用ChromID ESBL选择性显色平板做筛选试验,同时用纸片确证法做确证试验,采用Kappa检验对两者结果进行一致性分析。结果两种方法对371株肠杆菌科细菌ESBLs检测的总Kappa值为0.761。ChromID ESBL选择性显色平板法的总灵敏度为95.2%,总特异度为83.5%。对大肠埃希菌、肺炎克雷伯菌、奇异变形杆菌分别统计,其Kappa值分别为0.832、0.514、0.778;ChromID ESBL选择性显色平板法对其检测灵敏度分别为95.7%、91.3%、100.0%,特异度分别87.6%、72.9%、90.9%。另外有6株大肠埃希菌在该显色平板上显非特征色。结论 ChromID ESBL选择性显色平板对产ESBLs肠杆菌科细菌的筛选效果与纸片确证法总体的一致性较好,其灵敏度和特异度较高,可应用于临床。但该显色平板对产ESBLs肺炎克雷伯菌的筛选效果与纸片确证法一致性一般,其特异度也较低;对大肠埃希菌存在一定的假阴性,对于该显色平板上生长的绿色和白色菌落需要作进一步鉴定确认。
Objective To evaluate the screening effect of ChromID ESBL selective color plates on Enterobacteriaceae producing extended-spectrum β-lactamases (ESBLs). Methods 371 strains of Enterobacteriaceae clinically isolated were selected for ESBLs screening. ChromID ESBL selective chromogenic plates were used for screening tests. The confirmatory test was performed by the paper confirmatory test. The Kappa test was used to analyze the consistency of the two results. Results The total kappa value of ESBLs in 371 Enterobacteriaceae strains by two methods was 0.761. ChromID ESBL selective color plate method has a total sensitivity of 95.2% and a total specificity of 83.5%. The Kappa values of Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were 0.832, 0.514 and 0.778, respectively. The detection sensitivity of ChromID ESBL selective color plates was 95.7%, 91.3%, 100.0 %, Specificity of 87.6%, 72.9%, 90.9% respectively. In addition there are 6 strains of Escherichia coli in the chromogenic plate was non-characteristic color. Conclusion The screening results of ChromID ESBL selective color plates on ESBLs-producing Enterobacteriaceae are consistent with the overall validation of the disk-based validation method, and their sensitivity and specificity are high and can be applied to clinic. However, the color plate for producing ESBLs producing Klebsiella pneumoniae screening results and the consistency of the paper confirmed the general, the specificity is also low; there is a certain false negative for Escherichia coli, the growth of the color plate The green and white colonies need to be further identified and confirmed.