eCIM联合mCIM试验对肺炎克雷伯菌碳青霉烯酶分型的应用  

Application of eCIM combined with mCIM test in carbapenemase typing for Klebsiella pneumoniae

作　　者：尹娟[1] 朱超望[1] 眭阳[1] 周莉靖 江春 王莹超[1] YIN Juan;ZHU Chaowang;SUI Yang;ZHOU Lijing;JIANG chun;WANG Yingchao(Department of Clinical Laboratory,Suzhou Hosptial Affiliated to Nanjing Medical University/Suzhou State Hospital North District,Suzhou,Jiangsu 215008,China)

机构地区：[1]南京医科大学附属苏州医院/苏州市立医院北区检验中心

出　　处：《国际检验医学杂志》2019年第21期2568-2571,2575,共5页International Journal of Laboratory Medicine

基　　金：苏州科技计划指导性资助项目(SYSD2016120);南京医科大学科技发展基金资助项目(NMUB2018215)

摘　　要：目的应用乙二胺四乙酸改良碳青霉烯灭活法(eCIM)联合改良碳青霉烯灭活法(mCIM)检测肺炎克雷伯菌(KPN)中碳青霉烯酶的分型,并初步评估其用于分型的效能。方法以KPN为研究对象,eCIM联合mCIM试验分析产金属酶和丝氨酸酶碳青霉烯酶的表型,以PCR为金标准,评估eCIM联合mCIM试验检测碳青霉烯酶分型的准确率。结果检测94株耐碳青霉烯类KPN,其中87株mCIM试验阳性,为产碳青霉烯酶株;7株mCIM阴性,为非产碳青霉烯酶株。产碳青霉烯酶菌株中75株eCIM阴性,为丝氨酸酶表型;12株eCIM阳性,为金属酶表型。PCR检测碳青霉烯酶编码基因阳性株87株,其中丝氨酸酶KPC-2基因阳性76株,金属酶IMP基因阳性12株,1株同时携带KPC-2和IMP基因。χ2分析两种方法检测结果的一致性,差异无统计学意义(P>0.05)。结论eCIM联合mCIM试验检测KPN中碳青霉烯酶分型,与PCR结果一致,不需购买特殊试剂,操作简便,易于推广,可为临床抗感染用药及医院感染控制提供重要参考。Objective To detect the type of carbapenemase in Klebsiella pneumoniae(KPN)by using ethylenediaminetetraacetic acid modified carbapenem inactivation(eCIM)combined with modified carbapenem inactivation(mCIM)test and to preliminarily evaluate its typing ability.Methods The phenotypes of metalloenzymes and serinase-producing carbapenemases were analyzed by eCIM combined with mCIM in KPN.The accuracy of carbapenemase typing by eCIM combined with mCIM was evaluated by using PCR as the gold standard.Results A total of 94 strains of carbapenem resistant KPN were detected,87 strains of which were mCIM-test positive,and 7 strains of mCIM negative.A total of 75 strains of eCIM negative were serine enzyme phenotype,12 strains of eCIM positive were metal enzyme phenotype in the 87 strains.A total of 87 strains of carbapenemase coding genes were detected by PCR,76 strains carried serinase KPC-2 gene,12 strains carried metalloproteinase IMP gene and 1 strain carrying both KPC-2 and IMP genes.Two methods were showed good consistency(P>0.05).Conclusion The detection of carbapenemase in KPN by eCIM combined with mCIM is consistent with the results of PCR.Special reagents is not required.It is easy to operate and popularize.It can provide important theoretical reference for clinical anti-infective treatment and nosocomial infection control.

关 键 词：肺炎克雷伯菌 乙二胺四乙酸改良碳青霉烯灭活试验 碳青霉烯酶 金属酶 丝氨酸酶 

分 类 号：R372[医药卫生—病原生物学]