Carba NP直接纸片法检测肠杆菌科细菌碳青霉烯酶的应用评估  

Clinical evaluation of Carba NP paper strip test in detection of carbapenemase-producing Enterobacteriaceae

作　　者：胡锡池[1] 胡仁静[1] 刘小云 

机构地区：[1]南京医科大学附属无锡市第二人民医院检验科,江苏无锡214002 [2]徐州医科大学附属医院中心实验室,江苏徐州221002

出　　处：《临床与病理杂志》2017年第10期2043-2049,共7页Journal of Clinical and Pathological Research

基　　金：无锡市科技支撑项目(CSE31N1602)~~

摘　　要：目的:评估Carba NP直接纸片法快速检测肠杆菌科细菌产碳青霉烯酶菌株的实用价值。方法:收集2015年4月至2016年12月来自各类标本的肠杆菌科细菌212株,其中122株试验菌,90株对照菌分别进行Carba NP试验和Carba NP直接纸片法检测,同时将耐药基因的普通PCR的检测结果作为金标准。结果:在122株细菌中,KPC-2耐药基因阳性菌株为112株;NDM-1基因阳性菌株为8株;2株未检出耐药基因;未发现携带D组OX A-4 8基因的实验菌。与PCR结果相比,Car ba NP试验与Carba NP直接纸片法对于所测菌株的碳青霉烯酶的敏感性高达98%,特异性高达100%;Carba NP试验在60 min内完成检测,而Carba NP直接纸片法最快可以在5 min内完成检测。结论:相对于Carba NP试验,Carba NP直接纸片法无需昂贵的蛋白抽提液,试剂成本价廉,操作简便,可以有效协助临床抗感染治疗。Objective： To evaluate Carba NP paper strip test for the carbapenemase detection of carbapenem-resistant Enterobacteriaceae. Methods： A total of 122 Enterobacteriaceae were isolated from various clinical samples from the Second People’s Hospital between April 1, 2015 and December 31, 2016. The phenotype of Enterobacteriaceae were detected by Carba NP test and Carba NP paper strip test, the genes of carbapenemase detection were performed by PCR, which was regarded as a gold standard method to gene detection. Results： A total of 112 blaKPC-2 isolates, 8 blaNDM-1 isolates, no class D carbapenemase isolate, and 2 non-carbapenemase isolates were detected in 122 carbapenem-resistant Enterobacteriaceae. The sensitivity of Carba NP test and Carba NP direct paper to the carbapenemase of the tested strain was as high as 98% and the specificity was as high as 100%, refer to PCR results. Carba NP test can be done within one hour, and Carba NP paper strip test can be done within five minutes. Conclusion： Relative to the Carba NP test, Carba NP simple paper method does not need expensive protein extraction liquid, cheap and easy to operate, suitable for primary hospitals are widely used, which can effectively assist clinical anti-infection treatment.

关 键 词：CARBA NP直接纸片试验 碳青霉烯酶 检测价值 

分 类 号：R446.5[医药卫生—诊断学]