Vitek-AMS鉴定临床细菌的应用研究  

Identification of clinical isolates by means of Vitek-AMS

作　　者：孔繁林[1] 储从家[1] 管新龙[1] 李杰芬[1] 杨宇溪[1] 

机构地区：[1]玉溪市人民医院,云南玉溪653100

出　　处：《中国微生态学杂志》2010年第7期634-636,639,共4页Chinese Journal of Microecology

摘　　要：目的探讨Vitek-AMS对临床细菌鉴定的应用价值。方法对玉溪市人民医院1999年至2008年临床分离11 537株细菌(临床株)和省、部级临床检验中心下发微生物学室间质量评价鉴定菌种(参考株)的Vitek-AMS鉴定结果作对比分析。结果 11 537株临床分离菌中,不能鉴定细菌8株(0.07%);除外传染病因子,鉴定到属细菌114株(1.62%),鉴定到种(含亚种、物生型)细菌6 908株(98.38%)。共有64属193种。细菌类型的分布革兰阴性杆菌>革兰阳性球菌>酵母菌>革兰阳性杆菌>厌氧菌>革兰阴性球菌。用参考菌种作比较,Vitek鉴定种的符合率为83.08%(54/65),属的符合率为98.46%(64/65);其中革兰阴性杆菌符合率最高(100%,24/24),酵母菌类符合率最低(66.67%,14/21)。7种鉴定卡菌种的阳性检出率平均为56.80%(234/412),其中GPI卡最高(100%),NHI卡最低(13.33%);但应用机会最多是GNI+卡。Vitek-AMS检测葡萄球菌产β-内酰胺酶阳性率为88.89%,大肠埃希菌和肺炎克雷伯菌产ESBLs阳性率分别为59.74%和32.20%。结论 Vitek-AMS的应用为临床细菌学检验提供了一种高效、快速、可靠的实验方法;但对于个别菌种、细菌酶的检测必要时应以参考方法确认。Objective To explore the application value of Vitek-AMS in the identification of clinical isolates.Method 11 537 strains of bacteria clinically isolated in our hospital from 1999 to 2008 and reference strains from the National Center for Clinical Laboratory（NCCL） and the Center for Clinical Laboratory of Yunnan were identified by means of Vitek-AMS,and a comparative analysis was performed.Result Of the 11 537 strains of clinical isolates,8 strains （0.07%） were unidentifiable,114 strains（1.62%） were identified to genus,and 6908 strains（98.38%） were identified to species（including subspecies and biogroups）,excluding the factors of infections disease.There were a total of 193 species in 64 genera.The distribution of bacteriocin-types were gram-negative bacillus gram-positive coccus candids gram-positive bacillus anaerobes gram-negative coccus.The agreement rates for species and genus were 83.08%（54/65） and 98.46%（64/65） respectively in comparison with the reference strains,with the agreement rate for gramnegative bacillus being the highest（100%）,while that for candids being the lowest（66.67%）.The average positive rate of the bacterial species by the 7 identification cards were 56.80%（234 /412）,with the positive rate by GPI card being the highest（100%） and that by NHI card being the lowest（13.33%）,while the GNI＋ card was applied most frequently.The positive rate of Staphylacoccus producing β-lactamase was 88.89%（360 /405） by VITEK-AMS.The positive rates of ESBL-producing Escherichia coli and Klebsiella pneumoniae were 59.74%（319 /534） and 32.20%（51 /177） respectively.Conclusion Vitek-AMS provides a highly efficient,fast and reliable method for clinical bacteriological examination,although the results for a few species and bacterial enzymes need si opus sit verification with a reference method.

关 键 词：Vitek自动微生物系统 临床细菌 参考菌种 细菌鉴定 

分 类 号：R446.1[医药卫生—诊断学]