VITEK 2 Compact全自动微生物分析系统检测亚胺培南耐药鲍曼不动杆菌对阿米卡星的准确性评估  

Accuracy of VITEK 2 Compact for the determination of imipenem-resistant Acinetobacter baumannii to amikacin

作　　者：杨银梅[1] 陈斌[1] 彭颖仪 叶惠芬[1] 陈惠玲[1] 黄小媛[1] 

机构地区：[1]广州医科大学附属广州市第一人民医院检验科,广东广州510180

出　　处：《检验医学》2016年第10期907-910,共4页Laboratory Medicine

基　　金：国家自然科学基金项目(81201163);广东省医学科研基金项目(B2014341)

摘　　要：目的评价VITEK 2 Compact全自动微生物分析系统（简称VITEK 2 Compact）检测亚胺培南耐药鲍曼不动杆菌对阿米卡星药物敏感性试验结果的准确性,并了解其16S r RNA甲基化酶基因的存在情况。方法分别采用VITEK 2 Compact、纸片扩散法、E-test法检测72株临床分离的耐亚胺培南鲍曼不动杆菌和15株亚胺培南敏感的鲍曼不动杆菌对阿米卡星的敏感性,同时采用聚合酶链反应（PCR）检测其16S r RNA甲基化酶arm A基因。结果在72株耐亚胺培南鲍曼不动杆菌中,纸片扩散法和E-test法的结果均一致;有69株细菌VITEK 2 Compact检测最低抑菌浓度（MIC）为4~≥64μg/m L,而纸片扩散法和E-test法结果均为耐药;有3株细菌VITEK 2 Compact检测MIC为≤2μg/m L,纸片扩散法和E-test法有2株敏感;有59株细菌出现双圈耐药现象。在纸片扩散法及E-test法检测为阿米卡星耐药的70株鲍曼不动杆菌中,arm A基因阳性率为92.9%（65/70）。15株亚胺培南敏感鲍曼不动杆菌中,VITEK 2 Compact对阿米卡星的MIC均≤2μg/m L,纸片扩散法和E-test法的阿米卡星药物敏感性试验结果与VITEK 2 Compact一致,均为敏感。结论 VITEK 2 Compact在检测耐亚胺培南鲍曼不动杆菌对阿米卡星的敏感性时会出现不准确的结果,双圈耐药现象可能与携带16S r RNA甲基化酶基因arm A有关。ObjectiveTo evaluate the accuracy of VITEK 2 Compact automated microorganism analysis system for the determination of imipenem-resistantAcinetobacter baumannii to amikacin,and to investigate the existence of 16S rRNA methylase gene.Methods The drug susceptibilities of 72 isolates of imipenem-resistantAcinetobacter baumannii and 15 isolates of imipenem-sensitiveAcinetobacter baumannii to amikacin were determined by VITEK 2 Compact, Kirby-Bauer method and E-test. 16S rRNA methylasearmA gene was determined by polymerase chain reaction（PCR）. Results Among the 72 isolates of imipenem-resistantAcinetobacter baumannii,the drug susceptibility results were consistent between Kirby-Bauer method and E-test. The minimal inhibitory concentration（MIC）of 69 isolates was 4-≥64μg/mL by VITEK 2 Compact,while the results of Kirby-Bauer method and E-test showed being resistant. The MIC of 3 isolates were≤2μg/mL by VITEK 2 Compact,while there were 2 isolates being sensitive by Kirby-Bauer method and E-test. The resistant double-ring phenomenon was found in 59 isolates. The positive rate of carryingarmA gene was 92.9%（65/70）by Kirby-Bauer method and E-test. Among the 15 isolates of imipenem-sensitiveAcinetobacter baumannii, the MIC to amikacin was≤2μg/mL,and the results were in accordance with those of Kirby-Bauer method and E-test. ConclusionsVITEK 2 Compact is not reliable for the determination of imipenem-resistantAcinetobacter baumannii to amikacin. The resistant double-ring phenomenon might be related with carryingarmA gene.

关 键 词：鲍曼不动杆菌 亚胺培南 阿米卡星 armA基因 

分 类 号：R378.99[医药卫生—病原生物学]