快速多黏菌素NP法在肠杆菌科和鲍曼不动杆菌多黏菌素耐药性检测中的应用评价  

Evaluation of rapid polymyxin NP test for detecting polymyxin resistance in Enterobacteriaceae and Acinetobacter baumannii

作　　者：方人驰 田学斌 陈栎江[1] 赵雅洁 郑相阔 王冲 董郭枫 刘海洋[1] 曹建明[2] 周铁丽[1] FANG Renchi;TIAN Xuebin;CHEN Lijiang;ZHAO Yajie;ZHENG Xiangkuo;WANG Chong;DONG Guofeng;LIU Haiyang;CAO Jianming;ZHOU Tieli(Clinical Laboratory,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学附属第一医院医学检验中心,325000 [2]温州医科大学检验医学院生命科学学院

出　　处：《浙江医学》2020年第20期2161-2165,I0003,共6页Zhejiang Medical Journal

基　　金：“浙江省卫生高层次创新人才培养工程项目”资助浙卫发(2012)241号;温州市科技计划项目(Y20170204)。

摘　　要：目的评价快速多黏菌素NP法检测肠杆菌科(大肠埃希菌和肺炎克雷伯菌)多黏菌素耐药性的性能,并初步探究其在鲍曼不动杆菌多黏菌素耐药性检测中的应用价值。方法收集2010年至2019年温州医科大学附属第一医院临床分离多黏菌素耐药株42株,其中大肠埃希菌14株、肺炎克雷伯菌20株、鲍曼不动杆菌8株;同期多黏菌素敏感株120株,其中大肠埃希菌与肺炎克雷伯菌各50株、鲍曼不动杆菌20株。采用微量肉汤稀释法确认多黏菌素E最低抑菌浓度(MIC),同时使用快速多黏菌素NP试剂(含1%葡萄糖)检测肠杆菌科细菌对多黏菌素E的耐药性,并评价分别含1%、2%、4%葡萄糖浓度的快速多黏菌素NP试剂对检测鲍曼不动杆菌多黏菌素E耐药性的效果。结果以微量肉汤稀释法检测结果为标准,快速多黏菌素NP法检测肠杆菌科细菌多黏菌素E耐药性的灵敏度、特异度和准确率分别为100%(34/34)、99%(99/100)和99.3%(133/134);采用4%葡萄糖浓度的快速多黏菌素NP试剂,培养至16 h时对鲍曼不动杆菌多黏菌素耐药性检测的灵敏度、特异度和准确率也可达到100%(8/8)、90%(18/20)和92.9%(26/28)。结论快速多黏菌素NP法具有快速、简便、准确的优点,在肠杆菌科细菌的多黏菌素耐药性检测方面具有良好的应用价值,经改良后也可应用于鲍曼不动杆菌的多黏菌素耐药性检测,为当前临床快速可靠检测病原菌对多黏菌素耐药性提供了新的策略。Objective To evaluate the application of rapid polymyxin NP test in detecting polymyxin resistance in Enterobacteriaceae including Eshericha coli and klebsiella pneumoniae and Acinetobacter baumannii.Methods Forty two polymyxin-resistant clinical bacteria isolates were collected fromthe First Affiliated Hospital of Wenzhou Medical University during 2010 to 2019,including 14 strains of E.coli,20 strains of Klebsiella pneumoniae and 8 strains of A.baumannii.And 120 polymyxin susceptible strains were also collected during the same period,including 50 strains of E.coli and 50 strains K.pneumoniae and 20 strains of A.baumannii.The broth microdilution method was used to confirm the minimum inhibitory concentration(MIC)of polymyxin E.The rapid polymyxin NP reagent(containing 1%glucose)was used to detect the polymy xin E resistance of Enterobacteriaceae.And the performance of the rapid polymyxin NP reagent containing 1%,2%and 4%glucose concentrations on the detection of polymyxin E-resistant A.baumannii were evaluated.Results Using the results of the broth microdilution method as the gold standard,the sensitivity,specificity and accuracy of the rapid polymyxin NP test for detection of polymyxin E resistance in Enterobacteriaceae were 100%(34/34),99%(99/100)and 99.3%(133/134),respectively,at 4%glucose concentration,those for A.baumannii at 16 h of culture were also 100%(8/8),90%(18/20),and 92.9%(26/28),respectively.Conclusion The rapid polymyxin NP test is rapid,convenient and accurate,and has good value in the detection of polymyxin resistance of Enterobacteriaceae.It can also be applied to A.baumannii with modification.

关 键 词：药敏试验 多黏菌素 肠杆菌科 鲍曼不动杆菌 耐药性 

分 类 号：R969[医药卫生—药理学]