经修饰CHROMagar不动杆菌显色培养联合MALDI-TOF-MS快速筛查肠道耐碳青霉烯鲍氏不动杆菌的研究  

Modified CHROMagar Acinetobacter chromogenic culture combined with MALDI-TOF-MS for rapid screening of carbapenem-resistant Acinetobacter baumannii from human gut

作　　者：卫丽[1] 乔甫[1] 林吉[1] 黄文治[1] 张晓霞[2] 宗志勇[1,2] WEI Li;QIAO Fu;LIN Ji;HUANG Wen-zhi;ZHANG Xiao-xia;ZONG Zhi-yong(West China Hospital of Sichuan University,Chengdu,Sichuan 610000,China)

机构地区：[1]四川大学华西医院医院感染管理部,四川成都610000 [2]四川大学华西医院医院感染性疾病中心,四川成都610000

出　　处：《中华医院感染学杂志》2018年第19期2893-2897,共5页Chinese Journal of Nosocomiology

基　　金：四川省科技厅软科学基金资助项目(2017ZR0170)

摘　　要：目的探讨初步建立经修饰的CHROMagar不动杆菌显色培养联合基质辅助激光解吸电离飞行时间质谱(MALDI-TOF-MS)的方法用于快速筛查肠道耐碳青霉烯鲍氏不动杆菌(CRAB)。方法采集2017年4-6月入住医院ICU的319名患者直肠拭子并接种至含4μg/ml美罗培南的CHROMagar不动杆菌显色培养基,MALDI-TOF-MS鉴定可疑菌株。快速筛查结果用recA基因测序分析及美罗培南MIC值进行验证。结果快速筛查到18.18%(58/319)的患者肠道携带CRAB。recA基因测序分析显示该58株菌全为鲍氏不动杆菌,且有57株对美罗培南耐药,符合率高达98.28%(57/58)。结论经修饰的CHROMagar不动杆菌显色培养联合MALDI-TOF-MS可快速筛查肠道耐碳青霉烯鲍氏不动杆菌,特异性高、稳定性好,对医院感染早期监测与积极防控具有重要的应用价值。OBJECTIVE To establish a method combining modified CHROMagar Acinetobacter chromogenic culture with MALDI-TOF-MS for rapid screening of CRAB from human gut.METHODS Rectal swabs of 319 patients hospitalized in our ICU during Apr.to Jun.in 2017 were collected and inoculated to modified CHROMagar Acinetobacter chromogenic medium supplemented with 4 μg/ml meropenem.The suspicious strains were identified by MALDI-TOF-MS.Then the results of rapid screening were confirmed by recA gene sequencing analysis and meropenem MIC test.RESULTS A total of 58 patients with CRAB in their guts were rapidly screened by modified CHROMagar Acinetobacter chromogenic culture and MALDI-TOF-MS,with a detection rate of 18.18%（58/319）.The 58 strains were confirmed to be Acinetobacter baumannii by recA gene sequencing analysis,of which 57 strains were resistant to meropenem,with a coincidence rate of up to 98.28%（57/58）.CONCLUSION Modified CHROMagar Acinetobacter chromogenic culture combined with MALDI-TOF-MS has high specificity and good stability for rapid screening of CRAB in human gut,which is of great application value for early monitoring and active prevention of nosocomial infection.

关 键 词：CHROMagar不动杆菌显色培养基 基质辅助激光解吸电离飞行时间质谱 耐碳青霉烯鲍氏不动杆菌 直肠拭子 快速筛查 

分 类 号：R378[医药卫生—病原生物学]