异质性万古霉素中介金黄色葡萄球菌的分离率调查及方法学评价  

Isolation rate of heteroresistant vancomycin-intermediate Staphylococcus aureusand evaluation of screening methods

作　　者：许宏涛[1] 陈东科[1] 赖惠英[1] 胡云建[1] 张秀珍[1] 

机构地区：[1]北京医院检验科,北京100730

出　　处：《中华医院感染学杂志》2012年第21期4681-4683,共3页Chinese Journal of Nosocomiology

基　　金：首都医学发展科研基金(2009-3016)

摘　　要：目的调查异质性万古霉素中介金黄色葡萄球菌临床分离率,并对常用的检测方法进行评价。方法收集医院临床检出的180株MRSA,以改良菌群分析策略曲线下面积法(PAP-AUC)为金标准,应用含万古霉素4μg/ml BHI平皿(BHIV4)、含万古霉素6μg/ml BHI平皿(BHIV6)、含替考拉宁5μg/ml BHI平皿(BHIT5)、含16μg/L酪蛋白胰酶消化物和4μg/ml万古霉素的BHI平皿(CBHIV4)(菌悬液分别为0.5麦氏单位浓度、2.0麦氏单位浓度)和macroEtest(MET)法对所有菌株进行hVISA检测。结果共检测出15株hVISA,采用BHIV4、BHIV6、BHIT5、CBHIV4(用0.5麦氏单位菌悬液)、CBHIV4(用2.0麦氏单位浓度菌悬液)及MET法敏感度和特异性分别为:20.0%、99.4%;6.7%、98.8%;93.3%、42.4%;33.3%、92.1%;66.7%、69.1%及86.7%、59.4%。结论在MRSA中hVISA占有一定比例,应重视hVISA的检测;当前仍缺少一种简便、快捷、准确度高的检测hVISA的方法。OBJECTIVE To investigate the isolation rate of heteroresistant vancomycin-intermediate Staphylococcus aureus（hVISA） and evaluate the screening methods.METHODS A total of 180 MRSA strains were collected in clinical samples.PAP-AUC was used as gold standard.BHIV4 containing 4 μg/ml of vancomycin,BHIV6 containing 6 μg/ml of vancomycin,BHIT5 containing 5μg/ml of vancomycin,CBHIV4（with bacterial concentration of 0.5 and 2.0 McFarland respectively） and MET were used to detect hVISA in all MRSA strains.RESULTS A total of 15 hVISA（8.3%） strains were detected.The sensitivity and specificity of BHIV4,BHIV6,BHIT5,CBHIV4 with bacterial concentration of 0.5 McFarland,CBHIV4 with 2.0 McFarland,and MET were as follows：20.0%,99.4%;6.67%,98.8%;93.3%,42.4%;33.3%,92.1%;66.7%,69.1% and 86.7%,59.4%.CONCLUSION There is a certain proportion of hVISA in MRSA strains,we should pay more attention to the detection of hVISA,but currently,we still lack a simple,fast,accurate method to detect hVISA.

关 键 词：异质性中介 万古霉素 金黄色葡萄球菌 

分 类 号：R378.11[医药卫生—病原生物学]