摘要
目的探讨改良Carba Np试验快速检测血培养肠杆菌目细菌碳青霉烯类耐药表型的应用价值。方法选取2022年邢台市第三医院从临床血培养标本分离的163株耐碳青霉烯肠杆菌目细菌菌株,分别采用改良Carba Np试验、mCIM/eCIM对菌株进行表型检测,以PCR碳青霉烯酶表型鉴定结果为金标准,比较两种改良方法的检测结果。结果163株耐碳青霉烯肠杆菌目细菌有8个菌种,其中肺炎克雷伯菌数量最多,共134株(82.21%);其次是大肠埃希菌17株(10.41%)。科室来源中ICU居首位,72株(44.17%);其次为外科20株(12.27%)。药敏试验提示氨苄青霉素、头孢唑肟、头孢曲松、亚胺培南、厄他培南耐药率100%,头孢他啶、阿奇霉素、环丙沙星、左氧氟沙星耐药率高于90%,检测的16种抗菌药物中仅阿米卡星耐药率低于50%。表型检测结果显示,Carba Np试验阳性161株,阳性率98.77%;mCIM/eCIM试验阳性154株,阳性率94.47%;肺炎克雷伯菌、产酸克雷伯菌表型试验阴性。134株肺炎克雷伯菌中101株携带blaKPC-2,3株携带blaNDM,2株携带blaIMP,28株基因检测阴性;17株大肠埃希菌中5株携带blaKPC-2,9株携带blaNDM。以PCR结果为标准,改良Carba Np试验、mCIM/eCIM试验在耐碳青霉烯肠杆菌中均具有较高的灵敏度与特异性,两种方法的灵敏度与特异性差异无统计学意义(P>0.05)。结论改良Carba Np试验能快速鉴定碳青霉烯耐药肠杆菌目细菌菌株,具有较好的临床应用价值。
Objective To explore the application value of improved Carba NP test for rapid detection of carbapenemresistant phenotype of Enterobacteriaceae in blood culture.Methods A total of 163 strains of carbapenem-resistant Enterobacteriaceae isolated from clinical blood culture samples in Xingtai Third Hospital in 2022 were selected,the phenotypes of the strains were detected by improved Carba NP test and mCIM/eCIM respectively.The results of carbapenem phenotype identified by PCR were used as the gold standard to compare the tests of the two imoproved methods.Results The 163 strains of carbapenem-resistant Enterobacteriaceae included 8 strains,of which 134 strains were Klebsiella pneumoniae,accounted for 82.21%,followed by Escherichia coli,17 strains,accounted for 10.41%.Among 163 strains of carbapenem-resistant Enterobacteriaceae,ICU ranked first,with 72 strains,accounted for 44.17%,followed by surgery department,20 strains,accounted for 12.27%.The drug sensitivity test showed that the drug resistance rate was 100%to ampicillin,ceftizoxime,ceftriaxone,imipenem and ertapenem,the drug resistance rate to ceftazidime,azithromycin,ciprofloxacin and levofloxacin was over 90%.Among the 16 antibacterial drugs tested,only amikacin had a drug resistance rate below 50%.The results of phenotypic test showed that 161 strains were positive for carbNP test,with a positive rate of 98.77%.154 strains were positive in mCIM/eCIM test,and the positive rate was 94.47%.Two strains were negative in phenotypic test.In this study,163 strains of carbapenem-resistant Enterobacter were screened.Among 134 strains of Klebsiella pneumoniae,101 strains carried blaKPC-2 gene,3 strains carried blaNDM,2 strains carried blaIMP,and 28 strains were negative.Among the 17 strains of Escherichia coli,5 strains carried blaKPC-2 gene and 9 strains carried blaNDM.Based on the PCR results,the improved Carba Np test mCIM/eCIM test had high sensitivity and specificity in carbapenem-resistant Enterobacter,and there was no statistical difference between the two grou
作者
刘向芹
薛云
刘建晓
马芳
张凯
LIU Xiangqin;XUE Yun;LIU Jianxiao;MA Fang;ZHANG Kai(Clinical laboratory,Xingtai Central Hospital,Xingtai,Hebei 054000,China)
出处
《中国国境卫生检疫杂志》
CAS
2024年第3期276-279,共4页
Chinese Journal of Frontier Health and Quarantine
基金
邢台市重点研发计划项目(2021ZC111)。
