mCIM法与PAE-MHT法检测铜绿假单胞菌产金属β-内酰胺酶的性能评价  

Evaluation of Modified Carbapenem Inactivation Method and Pseudomonas Aeruginosa-MoeifiedHodge Test for Detection of Metallo-Lactamase-Producing Pseudomonas Aeruginosa

作　　者：谢国艳 蔡枫[1] 梁斌 裴凌燕 冯琪 XIE Guo-yan;CAI Feng;LIANG Bing;PEI Ling-yan;FENG Qi(Department of Clinical Laboratory,Shanghai Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海中医药大学附属市中医医院检验科,上海200071

出　　处：《现代检验医学杂志》2020年第1期57-59,64,共4页Journal of Modern Laboratory Medicine

摘　　要：目的评估改良的碳青霉烯类灭活法(mCIM)和铜绿假单胞菌改良Hodge试验(PAE-MHT)法对铜绿假单胞菌(PAE)产金属β-内酰胺酶(MBLs)的表型筛选能力。方法收集176株耐碳青霉烯类PAE,PCR检测IMP和VIM基因,采用mCIM法和PAE-MHT法检测产MBLs菌株,其中mCIM法分别选择亚胺培南(IMP)和美罗培南(MEM)作为药物底物进行筛选能力的研究,对几种方法与PCR检测结果的一致性进行统计分析。结果以IMP为底物mCIM法和以MEM为底物mCIM法检测MBLs的阳性率差异无统计学意义(χ^2=0.01,P>0.05)。以IMP为底物mCIM法、以MEM为底物mCIM法和PAE-MHT法的准确度分别为94.9%,96.6%和94.3%;敏感度分别为90.5%,100%和85.7%;特异度分别为95.5%,96.1%和95.5%。三者在准确度、敏感度和特异度之间两两相比,差异均无统计学意义(χ^2=0.01~2.99,均P>0.05)。三种方法与PCR法均具有良好的一致性。结论PAE-MHT法经济、操作简便,结果易于判读。以MEM为底物的mCIM法具有高敏感度与高特异度,更适合于检测PAE的MBLs。Objective To evaluate the screening capacity of modified carbapenem inactivation method( mCIM) and Pseudomonas aeruginosa-Moeified Hodge( PAE-MHT) test for detection of metallo-β-lactamase-producing( MBLs) in PAE. Methods176 carbapenem-resistant PAE clinical isolates were dectected to MBLs by mCIM and PAE-MHT test,respectively. Meanwhile,IMP genes and VIM genes were detected by PCR. The examination results were analyzed statistically. Results Comparing mCIM of imipenem-substrate methods to mCIM of meropenem-substrate method,the dectction rates of MBLs were not statistically significant( χ~2= 0. 01,P > 0. 05). For mCIM of imipenem-substrate,mCIM of meropenem-substrate and PAEMHT,the accuracy rate was 94. 9%,96. 6% and 94. 3%,respectively. The sensitivity was 90. 5%,100% and 85. 7%,respectively. The specificity was 95. 5%,96. 1% and 95. 5%,respectively. Pairwise comparison of accuracy,sensitivity and specificity among the three groups showed no statistically significant difference( χ~2= 0. 001 ~ 2. 99,all P > 0. 05). Three methods had a good consistency compared with PCR. Conclusion PAE-MHT test is a method of economical,practical and simple operation. The mCIM of meropenem-substrate is high sensitivity and good specificity for detecting MBLsproducing PAE.

关 键 词：改良碳青霉烯类失活法 铜绿假单胞菌 金属Β-内酰胺酶 评估 

分 类 号：R378.991[医药卫生—病原生物学] R446.5[医药卫生—基础医学]