三种表型试验单用和联用鉴定金黄色葡萄球菌能力的评估  

Evaluation of the capability of three phenotypic tests used alone or in combination for identificationof Staphylococcus aureus

作　　者：陈旭[1] 顾飞飞[1] 李洁[1] 萧晨路[1] 韩立中[1] 倪语星[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院临床微生物科,200025

出　　处：《中华微生物学和免疫学杂志》2013年第5期355-359,共5页Chinese Journal of Microbiology and Immunology

摘　　要：目的对单个和联合三个表型生化试验鉴定金黄色葡萄球菌进行评价。方法以PCR检测spa基因以及Vitek-2系统鉴定结果作为参考方法，分析比较DNA酶试验（DNase）、高盐甘露醇平板生长试验（MSA）、试管法测血浆凝固酶（TCT）单用鉴定金黄色葡萄球菌的敏感度、特异性、阳性预测值、阴性预测值、阳性似然比、阴性似然比、约登指数等参数，并分析联合应用三者鉴定金黄色葡萄球菌这一方案与参考方法的一致性、经济成本和相关诊断参数。结果本研究共收集到葡萄球菌属菌株324株，其中金黄色葡萄球菌293株、非金黄色葡萄球菌3l株，单个表型试验不能准确地鉴定金黄色葡萄球菌，联合三个表型试验方案与参考方法的一致性较好（Kappa值为0．9441）、经济成本较低，敏感度和特异性分别为100％、90．3％。结论DNA酶试验、高盐甘露醇平板生长试验和试管法测血浆凝固酶三者联合可以经济有效地鉴定金黄色葡萄球菌。Objective To evaluate the capability of three tests used alone or in combination for identification of Staphylococcus aureus. Methods Identification of Staphylococcus aureus by the detection of spa gene with PCR and the Vitek-2 system were selected as the reference methods. Comparison of three phe- notypic tests including DNase, mannitol fermentation and tube eoagulase test was carried out to analyze the sensitivity, specificity, positive/negative predictive value, positive/negative likelihood ratio and Youden in- dex. The consistency, cost and related indexes of the assays were analyzed between the combined phenotypic tests and the reference methods. Results In the present study, 324 isolates of Staphylococci, including 293 Staphylococcus aureus and 31 non-Staphylococcus aureus, were collected. Single biochemical test could not identify Staphylococcus aureus efficiently. Comparison between the reference methods and the combined three biochemical tests by Kappa statistic analysis indicated that an overall Kappa value was 0.9441, and the algo- rithm of combined test was less costly. The sensitivity and specificity of this algorithm were 100% and 90.3%, respectively. Conclusion The cost-effective algorithm of combined DNase, mannitol fermentation and tube coagulase test could efficientlv distinguish Staphylococcus aureus from other Staphylococcus species.

关 键 词：金黄色葡萄球菌 细菌鉴定 经济有效 生化试验 

分 类 号：R446[医药卫生—诊断学]