摘要
目的初步探索改良Carba NP法检测碳青霉烯酶的临床意义。方法利用BD MIC法对收集的6株耐碳青霉烯菌株进行药敏实验;同时采用改良Carba NP法进行产酶分析和初步分类;最后用PCR方法进行碳青霉烯酶基因鉴定。结果此6株菌对青霉素类、单环内酰胺类和头孢菌素类(除外四代头孢,头孢吡肟)和碳青霉烯类抗生素均耐药;改良Carba NP显示菌株1、2和5产B类碳青霉烯酶,菌株6产A类碳青霉烯酶,菌株3和4不产酶;耐药基因扩增结果为菌株1、2和5均含有blaNDM,菌株6含有blaKPC,菌株3和4耐药基因扩增结果为阴性。结论改良Carba NP可以快速、直观和可靠地鉴定临床菌株是否产酶,且可以准确地进行碳青霉烯酶基因分型,从而可以早期监测碳青霉烯类耐药菌株,有利于临床正确合理应用抗生素,延缓细菌耐药的步骤。
Objective To evaluate the clinical significance of modified Carba NP test for carbapenemase detec- tion. Methods Six carbapenem - resistance strains were collected. The MIC values were screened out by BD automatic bacterial identification. The carbapenemase - producing were detected by modified Carba NP test. PCR amplification was used to verify the drug resistance gene types of carbapenemase. Results All the 6 strains were resistant to penicillins, monobactams,cephalosporins ( Strain 2 and Strain 6 were susceptible to cefepime) and carbapenem. According to modi- fied Carba NP test,Strain 1,2,5 and 6 were shown positive,among which Strain 1,2 and 5 were Class B carbapenemase - producing isolates,and Strain 6 was Class A carbapenemase - producing isolate. The PCR results showed that Strain 1, 2 and 5 were NDM carbapenemase - producing strains,Strain 6 was KPC carbapenemase - producing strain,and Strain 3 and 4 were negative with modified Carba NP test and PCR amplification. Conclusion The modified Carba NP test can quickly,visually and reliably identify the carbapenemase - producing isolates,and precisely verify the drug resistance gene types of carbapenemase. So it can provide evidence - based basis for early detection of carbapenems - resistance isolates,and provide a guidance to slow down bacteria drug resistance.
作者
刘东
张倩
王倩薇
毛英格
王丽
LIU Dong;ZHANG Qian;WANG Qian - wei;MAO Ying - ge;WANG Li(Department of Clinical Laboratory,the First Hospital Affiliated to Henan University,Kaifeng 475000,Henan,China)
出处
《广东医学》
CAS
2019年第10期1372-1375,共4页
Guangdong Medical Journal
基金
河南省高等学校重点科研项目(编号:18A320024)
开封市科技发展计划项目(编号:1703006)
