一种同时鉴定和检测产超广谱β内酰胺酶细菌的方法  

A simple method for identification and detection of extended-spectrum β-lactamases in Escherichia coil and Klebsiella pneumoniae

作　　者：胡付品[1] 叶信予[1] 朱德妹[1] 

机构地区：[1]复旦大学附属华山医院抗生素研究所,上海200040

出　　处：《中华检验医学杂志》2007年第10期1181-1185,共5页Chinese Journal of Laboratory Medicine

基　　金：国家973计划资助项目(2005CB523101)

摘　　要：目的评价含64μg/ml 头孢噻肟的 CHROMagar 尿道菌定位琼脂在检测产超广谱β内酰胺酶(ESBLs)细菌中的作用。方法以美国临床和实验室标准协会(CLSI)推荐的酶抑制剂增强试验检测产 ESBLs 菌株结果为标准,评价含头孢噻肟 CHROMagar 尿道菌定位琼脂在检测产 ESBLs 细菌的敏感度和特异度。菌株鉴定采用 API 条。结果在上海华山医院临床分离的260株大肠埃希菌和287株肺炎克雷伯菌中,CISI 推荐的酶抑制剂增强试验检测产 ESBLs 菌株分别为175株、200株。含64μg/ml头孢噻肟 CHROMagar 尿道菌定位琼脂检测产 ESBLs 菌株分别为172株、197株。与 CLSI推荐的酶抑制剂增强试验检测结果相比,含64μg/ml头孢噻肟 CHROMagar 尿道菌定位琼脂检测大肠埃希菌中产 ESBLs 菌株的敏感度、特异度和准确性分别为98.3%(172/175)、100%(85/85)和98.8%(257/260),肺炎克雷伯菌中产 ESBLs 菌株的敏感度、特异度和准确性分别为98.5%(197/200)、100%(87/87)和98.9%(284/287)结论含64μg/ml 头孢噻肟 CHROMagar 尿道菌定位琼脂在鉴定大肠埃希菌和肺炎克雷伯菌的同时即能检测是否为产 ESBLs 菌株,不失为一种简便快捷的方法,值得在临床微生物实验室推广应用。Objective To evaluate the effective of Chromogenic Agar method of identification and detectiong extended-spectrum β-lactamases （ ESBLs ） strains in Escherichia coli and Klebsiella pneumoniae. Methods The sensitivity and specificity of detection of ESBLs with Chromogenic Agar method were evaluated with in Escherichia coli （CLSI） method as reference. Results Among 260 E. coli, 287 K. pneumoniae from Huashan hospital, 175 produce ESBLs and 200 produce ESBLs by CLSI method, respectively. 172 produce ESBLs and 197 produce ESBLs by Chromogenic Agar method, respectively. The sensitivity, specificity, and accuracy of detection of ESBLs in Escherichia coli with Chromogenic Agar method were 98.3% （ 172/175 ）, 100% （ 85/85 ）, and 98. 8% （ 257/260 ）, while in klebsiella pneumomiae the sensitivity,specificity, and accuracy were 98. 5% （ 197/200）, 100% （87/87）, and 98. 9% （284/287）, respectively. Conclusions The Organism Identification and ESBLs detection in E. coli and K. pneumoniae can be done at the same time by Chromogenic Agar method. Chromogenic Agar method with advantages of easy operation has a good coincidence with CLSI method.

关 键 词：Β内酰胺酶类 头孢噻肟 琼脂 

分 类 号：R446.5[医药卫生—诊断学]