头孢西丁纸片扩散法检测耐甲氧西林葡萄球菌的临床应用  

Detection of Methicillin-resistant Staphylococcus Using the Cefoxitin Disk Diffusion Method

作　　者：耿燕[1] 王香玲[1] 李妙羡[1] 贺军涛[1] 张毅[1] 

机构地区：[1]西安交通大学医学院第二附属医院检验科,西安710004

出　　处：《现代检验医学杂志》2010年第3期71-73,共3页Journal of Modern Laboratory Medicine

摘　　要：目的以PCR检测耐甲氧西林葡萄球菌（MRS）mecA基因为金标准，评价头孢西丁纸片扩散法检测MRS的临床应用。方法收集各种细菌感染性标本分离到的葡萄球菌，细菌的鉴定采用法国梅里埃全自动微生物分析系Vitek-60，分别采用PCR扩增mecA法、头孢西丁纸片扩散法、苯唑西林纸片扩散法和抗青霉素结合蛋白2a（抗PBP2a）胶乳凝集法检测葡萄球菌中MRS。结果经PCR检测mecA证实西安地区SA中MRSA的发生率为69．2％（54／78），CNS中MRCNS的发生率为67．7％（65／96）；其余三种方法检测SA中的MRSA发生率分别为67．9％，57．7％，66．7％，CNS中MRCNS的发生率分别为64．6％，58．3％，63．5％。头孢西丁纸片扩散法与mecA基因法结果相比较检测MRSA，其灵敏度和特异度分别为98．1％和100．0％，两者符合率为98．7％；MRSCoN的灵敏度和特异度分别为95．4％扣100．0％，两者符合率为96．9％。结论头孢西丁纸片扩散法检测MRSA的敏感度和特异度高于苯唑西林纸片扩散法，与PCR检测mecA法具有较好的一致性，可作为临床实验室常规检测MRS的常规方法。Objective To evaluate the clinical effectiveness of cefoxitin disk diffusion method in detecting MRS using PCR amplification of mecA gene as reference,oxacillin and oxacillin salt agar method. Methods MecA gene of Staphylococcus was amplified by PCR. The susceptibility of Staphylococcus strains to cefoxitin,oxaeillin disk diffusion method for detecting MRS was tested by Kirby-Bauer method. Results All the 174 Staphylococcal strains isolated from clinical,69.2% （54/78） was MRSA and 67.7% （65/96） was MRCNS confirmed by PCR amplification of mecA gene. Results obtained by cefoxitin disk diffusion method：67.9%（53/78） was MRSA and 64.6% （62/96） was MRCNS. The sensitivity and specificity of cefoxitin disk diffusion for the detection of MRS were 98. 1 % （53/ 54） and 100.0% （24/24） respectively. Conclusion Cefoxitin disk diffusion method can be used reliably in detecting and confirming MRS. Cefoxitin disk diffusion method is highly sensitive and specific for the detection of methicillin-resistant Staphylococcus. It is applicable in clinical microbiology laboratory.

关 键 词：头孢西丁纸片扩散法 甲氧耐苯唑西林葡萄球菌(MRs) PCR MECA 

分 类 号：R446.5[医药卫生—诊断学]