超广谱β-内酰胺酶检出方法的比较分析  

Detection of Extended-spectrum β-Lactamase: A Comparative Analysis

作　　者：赵建平[1] 韩晓芳[1] 燕成岭[1] 王文灏[1] 周秀岚[2] 

机构地区：[1]内蒙古自治区医院,内蒙古呼和浩特010017 [2]内蒙古医学院第一附属医院,内蒙古呼和浩特010050

出　　处：《中华医院感染学杂志》2002年第7期504-506,共3页Chinese Journal of Nosocomiology

基　　金：内蒙古自治区自然科学基金资助项目(编号20001306)

摘　　要：目的 比较分析3种超广谱β-内酰胺酶（ESBLs）的检测方法,探讨适用本地区的快速简便方法。方法 选用纸片扩散初筛法,双纸片协同法,标准纸片扩散确认法进行试验。结果 在双纸片协同法中,AMX/CA与底物出现协同现象的频率从高到低依次为AZT（8 6.1％）、CRO（8 3.3％）、CTX（77.8％）、CFP（6 9.4％）、CAZ（41.7％）,中心间距为（20、25、30）mm时,出现协同现象的总频率分别为71.7％、67.8％、58.9％;确认试验中CAZ组检出率为81.1％,CTX组为91.1％;双纸片协同法与确认法的结果比较,符合率达97.3％,总检出率为10.2％。结论 双纸片协同法中,最佳底物为AZT,CRO,CTX,最差底物为CAZ,中心间距为20mm时检出率最高,确认试验中,CTX组检出率高于CAZ组,双纸片协同法可适用于中低级微生物实验室的推广使用。OBJECTIVE To compare and analyse three detection methods of ESBLs and to detect the high-speed method convenient to our Autonomous Region. METHODS Disc diffusion methods including disc screening test, double-disc synergy method K-B disc diffusion method and disc confirmatory test were used. RESULTS In double-disc synergy test, the rate of synergy phenomenon between amoxicillin/clavulanate and aztreonam, between amoxicillin/clavulanate and ceftriaxone, between amoxicillin/clavulanate and cefotaxime, between amoxicillin/ clavulanate and cefoperazone and between amoxicillin/clavulanate and ceftazidime was 86. 1% , 83. 8% , 77.8% , 69. 4% and 41. 3%, respectively. At different intervals of center margins(20 mm, 25 mm, 30 mm), the average rate of synergy phenomenon was 71. 7% , 67. 8% and 58. 9% , respectively. The detection rate was 81. 1% and 91. 1%, respectively for ceftazidime and cefotaxime by confirmatory test. Comparing the result of double-disc synergy test with confirmatory test , the coincidence rate is 9 7 . 3 % . The average detection rate of ESBLs was 10. 2%. CONCLUSIONS In double-disc synergy test, the best substrates were aztreonam, ceftriaxone and cefotaxime, and the worst one was ceftazidime. The detection rate was the highest when center margin was 20 mm. In confirmatory test, the detection rate for cefotaxime was higher than ceftazidime. Double-disc synergy test is appropriate to the rudimentary microbe laboratory.

关 键 词：超广谱Β-内酰胺酶 微生物检验 细菌耐药 纸片筛选法 双纸片扩散法 药敏试验 

分 类 号：R446.5[医药卫生—诊断学]