Carba NP试验用于检测肠杆菌科细菌产碳青霉烯酶的评价  

Evaluation of the Carba NP test to detect carbapenemase-producing Enterobacteriaceae

作　　者：杨燕[1] 陈坚[1] 孙倩 林迪[1] 成军[1] 孙长贵[1] 

机构地区：[1]解放军第一一七医院检验科,杭州310013

出　　处：《中华检验医学杂志》2016年第2期99-102,共4页Chinese Journal of Laboratory Medicine

基　　金：南京军区医学科技创新重点课题（102037）

摘　　要：目的评价CarbaNP试验检测碳青霉烯类非敏感的肠杆菌科细菌产碳青霉烯酶的效果。方法采用CarbaNP试验和改良的Hodge试验检测解放军第一一七医院2010年1月至2014年12月临床标本中分离的253株碳青霉烯类非敏感的肠杆菌科细菌，以PCR基因检测结果为金标准，采用SPSS19．0版本软件对其进行x。检验。结果253株碳青霉烯类非敏感的肠杆菌科细菌，用改良Hodge试验检出188株阳性，65株阴性；CarbaNP试验检出175株阳性，77株阴性，1株无效；PCR法检测碳青霉烯酶耐药基因，177株阳性，76株阴性。CarbaNP试验的敏感度为98．9％（175／177），改良的Hodge试验的敏感度为98．3％（174／177），两者差异无统计学意义（x2=0．5，P=0．48）；CarbaNP试验的特异度为100．0％（76／76），改良的Hodge试验的特异度为81．6％（62／76），CarbaNP试验明显优于改良的Hodge试验（x2=12．1，P〈0．05）。CarbaNP试验阳性出现时间以产KPC型酶菌株最快。结论CarbaNP试验快速简便，具有很好的敏感度和特异度，但还存在不足有待进一步完善。Objective To evaluate the performance of Carba NP test （CNP） for detection of carbapenemases in carbapenem-non-susceptive Enterobacteriaceae. Methods Carbapenemases in Enterobacteriaceae strains isolated from clinical specimens in the 117th hospital of PLA from January 2010 to December 2014 were detected by both CNP and modified Hodge test （MHT）, and corresponding results were analyzed and compared by Chi-square Using SPSS version 19.0. Data acquired from PCR were used as the standard. Results Of the 253 carbapenem-non-susceptive Enterobacteriaceae strains, 188 positive strains and 65 negative strains were detected by MHT, and 175 positive strains, 77 negative strains and 1 undetectable strain were detected by CNP, while 177 positive strains and 76 negative strains were detected by PCR. Sensitivities of two tests were comparable [ CNP, 98.9% （ 175/177 ）, versus MHT, 98.3% （174/177） ; X2 = 0. 5, P = 0.48 ], but CNP was more specific [ 100. 0% （76/76） versus 81.6% （62/76）; = 12. 1, P 〈0. 05 ]. Positive result in the CNP was emerged earliest in a KPC-producing strain. Conclusion The CNP is rapid and simple, which have good sensitivity and specificity. Yet further perfection is still needed in the future.

关 键 词：肠杆菌科 抗药性 细菌 微生物敏感性试验 敏感性与特异性 诊断技术和方法 

分 类 号：R446.5[医药卫生—诊断学]