两种方法在筛选产金属β-内酰胺酶鲍曼不动杆菌中的应用价值  

The appliacation value of two methods in the screening of Acinetobacter baumannii producing metallo-β-lactamase

作　　者：潘娟[1] 杨耀斌 刘凤[1] 吕纯莉[1] 陈安林[1] 陈泽慧[1] 

机构地区：[1]遵义医学院附属医院检验科,贵州遵义563003 [2]贵州省遵义市桐梓县人民医院,563200

出　　处：《检验医学与临床》2013年第14期1781-1782,1785,共3页Laboratory Medicine and Clinic

基　　金：贵州省科学技术厅基金资助项目(黔科合J字[2010]2215号)

摘　　要：目的以E-test法、双纸片增效法筛选产金属β-内酰胺酶(MBL)鲍曼不动杆菌(Ab),为临床筛选产MBL菌株、探究Ab耐药机制提供依据。方法使用MicroScan Walkway-40全自动微生物分析仪及MicroScanNegative Combo Panel Type31复合板进行菌株鉴定和药敏试验,筛选出泛耐药Ab,再分别用双纸片增效法、E-test法检测产MBL菌株。结果从298株Ab中筛选出38株泛耐药菌,经双纸片增效法筛选出MBL阳性19株(50.0%);E-test法筛选出MBL阳性18株(47.4%),两种方法阳性率差异无统计学意义(P>0.05)。结论双纸片增效法、E-test法操作简单,均可用于MBL表型的快速筛查;但由于E-test法成本昂贵,不适宜在临床实验室推广;双纸片增效法成本低廉,适合在广大临床实验室特别是基层医院实验室推广。Objective Using E-test method and double-disk synergy method to screen of metallo-β-lactamase（MBL） produced by Acinetobacter baumannii for clinical,and to provide the basis for exploring mechanisms of Acinetobacter baumannii resistance.Methods Strains identification and drug-susceptibility test were conducted by Microscan Walkway-40 automatic microbiology analyzer and MicroScan Negative Combo Panel Type31 composite panels to select the pan-drug resistant Acinetobacter baumannii,and then double-disk synergy method and E-test method were separately conducted to detect strains producing MBL.Results 38 extensively drug-resistant strains were detected from 298 Acinetobacter baumannii.19 strains producing MBL were picked by double-disk synergy method（50.0%）.18 strains were picked by E-test method（47.4%）.There was no significant difference between the positive rates of the two methods（P〈0.05）.Conclusion Both double-disk synergy method and E-test method are easy to operate and can be used for rapid screening of MBL phenotype.E-test method is not suitable for promotion in the clinical laboratory due to high cost,but double-disk synergy method suitable for promotion in the majority of clinical laboratories,particularly in the grassroots hospitals due to its low cost.

关 键 词：E-TEST法 双纸片增效法 鲍曼不动杆菌 金属Β-内酰胺酶 泛耐药 

分 类 号：R978.11[医药卫生—药品]