CIM,mCIM 和MHT筛选肠杆菌科细菌产碳青霉烯酶的方法评价  

Evaluation of CIM,mCIM and MHT Screening Methods for Carbapenem-producing Enterobac Teriaceae

作　　者：曹蕾[1] 李小月[1] 罗庆礼[2] 王亚平 CAO Lei;LI Xiao-yue;LUO Qing-li;WANG Ya-ping(Department of Medical Laboratory,the First People's Hospital of Anqing,Anhui Anqing 246003,China;Department of Pathogenic Biology,Anhui Medical University,Hefei 230000,China)

机构地区：[1]安庆市第一人民医院检验科,安徽安庆246003 [2]安徽医科大学病原生物学教研室,合肥230000

出　　处：《现代检验医学杂志》2020年第1期67-70,共4页Journal of Modern Laboratory Medicine

基　　金：安徽省科技厅项目(项目编号:1704f0804035)。

摘　　要：目的评估碳青霉烯类抑制法(carbapenem inactivation method,CIM)、改良碳青霉烯类失活法(modified carbapenem inactivation method,mCIM)和改良Hodge试验(modified hodge test,MHT)对肠杆菌科细菌碳青霉烯酶表型筛选能力。方法以PCR检测碳青霉烯酶基因作为金标准,对120株耐碳青霉烯类肠杆菌科细菌(carbapenem-resistant enterbacteriaceae,CRE)和50株碳青酶烯类敏感的肠杆菌科细菌,分别进行CIM,mCIM和MHT表型筛选试验,评估三种方法的表型筛选能力。结果120株CRE中,93株携带碳青霉烯酶耐药基因,表型筛选试验显示,CIM,mCIM和MHT的敏感度分别是95.6%,96.8%和95.8%,特异度分别为72.7%,92.3%和50%。三种方法筛选碳青霉烯酶,差异有统计学意义(χ^2=12.796,P<0.05)。与PCR结果相比较,CIM,MHT和mCIM的一致率分别为90%,95%和77.4%,Kappa值分别为0.898,0.949和0.771。mCIM和CIM试验与PCR高度一致。50株碳青酶烯类敏感的肠杆菌科细菌PCR检测和三种方法均为阴性。结论三种表型筛选方法均有较高的敏感度,但mCIM较CIM,MHT具有更高的特异度和一致率,是筛选CRE的有效方法。Objective To evaluate the screening ability of carbapenem inactivation method( CIM),modified carbapenem inactivation method( mCIM) and modified Hodge test( MHT) for carbapenem enzyme phenotype of Enterobacteriaceae bacteria.Methods PCR method was used to detect the genes of carbapenemase in Enterobacteriaceae bacteria,and the results were utilized as the standard of the phenotype screening capacity of CIM,mCIM and MHT test for 120 isolates of carbapenem-resistant Enterobacteriaceae and 50 sensitive strains. Results Among 120 CRE strains,93 strains carried carbapenemase resistance genes. Phenotypic screening tests showed that the sensitivity of CIM,mCIM and MTH were 95. 6%,96. 8% and95. 8%,respectively. The specificity of the three phenotypic screening methods was 72. 7%,92. 3% and 50%,respectively.There were significant differences among the three methods( χ2= 12. 796,P < 0. 05). Compared with PCR,the consistency rates of the three methods were 90%,95% and 77. 5%,and the Kappa values of the three methods were 0. 898,0. 949 and0. 771,respectively. 50 strains of carbapenem-sensitive Enterobacteriaceae bacteria were detected by PCR and all three methods were negative. Conclusion All three phenotypic screening methods had high sensitivity,but mCIM had higher specificity and consistency than CIM and MHT. mCIM is an effective method for screening CRE.

关 键 词：肠杆菌 碳青霉烯酶 碳青霉烯类抑制试验 改良碳青霉烯类失活试验 改良HODGE试验 

分 类 号：R378.2[医药卫生—病原生物学] R446.5[医药卫生—基础医学]