同时产ESBLs和AmpC酶菌株的表型检测及其意义  

Study of Detection Method and Its Clinical Application of Bacteria Producing AmpC and ESBLs

作　　者：陈天宝[1] 陈建魁[1] 于农[1] 尹秀云[1] 张树增[1] 

机构地区：[1]军事医学科学院附属医院检验科

出　　处：《中国误诊学杂志》2008年第24期5802-5803,共2页Chinese Journal of Misdiagnostics

摘　　要：目的:探讨同时产ESBLs和AmpC酶菌株的表型检测方法。方法:应用VITEK2微生物鉴定系统鉴定临床分离的细菌标本,用双纸片增效确证试验进行验证。对产ESBLs的细菌,用头孢西丁筛查试验、三维试验、Tris-EDTA法和粗提酶检测法检测AmpC酶。结果:365株肠杆菌科细菌中检出ESBLs菌株93株(25.5%),CLSI确证试验阳性菌株88株(94.6%)。头孢西丁筛查阳性的26株菌中检出同时产ESBLs和AmpC酶菌1株。结论:应用表型检测法可在临床标本中检出同时产ESBLs和AmpC酶菌株;以CSLI确证试验检测ESBLs,以酶粗提物直接测定法、Tris-EDTA法进行AmpC酶检测,对同时产两种酶的临床菌株进行筛查。其操作易行、结果可靠、便于临床推广应用。Objective：To study the method for phenotype detection of ESBI.s and AmpC in the same clinical iso late and to apply the method to the clinical drug resistant bacteria determination. Methods ：Clinical isolates were detected by VETEK 2 microbiological analyzing system. ESBI. producing strains were confirmed by double disk confirmatory test. Bacteria producing resistance to cefoxitin were detected by Tris EDTA disk and direct crude enzyme methods in comparison with three-dimensional tests. Results ： 88 ESBLs producing strains were confirmed by double disk test in 93 clinical isolates identified by VITEK 2 system. 1 of the 26 strains unsusceptible to cefoxtin was positive by three-dimen- sional test,Tris-EDTA disk method and crude enzyme detection. Conclusions：Clinical strain producing AmpC together with ESBLs have been found in our hospital. Direct crude enzyme and Tris-EDTA were easy and reliable methods for the detection of drug resistant bacteria in clinical microbiology laboratory.

关 键 词：β内酰胺酶类/分析 细菌蛋白质类/分析 肠杆菌科/酶学 表型 

分 类 号：R37-33[医药卫生—病原生物学]