双浓度联合改良碳青霉烯灭活试验筛查CRE的临床应用价值  

Role of double concentration combined modified carbapenem inactivation test for screening CRE

作　　者：李世荣[1] 林怡菁 蒋晓飞[1] 关明[1] LI Shirong;LIN Lijing;JIANG Xiaofei;GUAN Ming(Department of Clinical Laboratory,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院检验科,上海200040

出　　处：《检验医学》2020年第10期979-982,共4页Laboratory Medicine

摘　　要：目的评估双浓度联合改良碳青霉烯灭活试验(mCIM)筛查碳青霉烯类耐药肠杆菌科细菌(CRE)的临床应用价值。方法以VITEK 2 Compact N335卡的体外药物敏感性试验结果为标准,采用双浓度联合mCIM在231株分离自临床样本的肠杆菌科细菌中筛查CRE。结果VITEK 2 Compact N335卡筛选出CRE阳性菌株52株,阴性菌株179株,阳性检出率为22.5%;mCIM筛出CRE阳性菌株52株,双浓度联合mCIM筛出CRE阳性菌株53株,阴性菌株178株,阳性检出率为22.9%。以VITEK 2 Compact检测结果为参考,符合率为98.7%,敏感性为98.1%,特异性为98.9%;将mCIM检测阳性的52株CRE继续进行乙二胺四乙酸改良碳青霉烯灭活试验(eCIM),结果显示有13株肠杆菌科细菌金属-β-内酰胺酶为阳性,金属-β-内酰胺酶占碳青霉烯酶的25%。结论双浓度联合mCIM筛查CRE具有操作简单、不需要特殊仪器、结果易于观察等优点,适合在各级医院的微生物实验室中推广使用。对mCIM阳性菌株加做eCIM非常必要,有利于临床个性化用药。Objective To evaluate the role of double concentration combined modified carbapenem inactivation method(mCIM)for screening carbapenem-resistant Enterobacteriaceae(CRE).Methods Based on the drug susceptibility test of VITEK 2 Compact N335 card,231 isolates of Enterobacteriaceae isolated from clinical samples were screened for CRE by double concentration combined mCIM.Results Totally,52 isolates of CRE were screened by VITEK 2 Compact N335 card,179 isolates were negative,and the positive rate was 22.5%.Totally,52 isolates of CRE were screened by mCIM.A total of 53 isolates of CRE were screened by double concentration combined mCIM,178 isolates were negative,and the positive rate was 22.9%.Based on the durg susceptibility test of VITEK 2 Compact N335 card,the consistency rate,sensitivity and specificity were 98.7%,98.1%and 98.9%,respectively.A total of 52 isolates with positive mCIM results were continued to do ethylenediamine tetraacetic acidmodified carbapenem inactivation method(eCIM).The results showed that 13 isolates of Enterobacteriaceae were metallo-β-lactamase positive,and the positive rate of carbapenemases was 25%.Conclusions The double concentration combined mCIM for CRE screening has the advantages of simple operation,no need for special instruments and easy observation of results.It is suitable for using in all level microbiological laboratories.It is necessary for mCIM positive isolates to do eCIM again,which is conducive to individualized drug use in clinic.

关 键 词：双浓度筛查法 改良碳青霉烯灭活试验 碳青霉烯类耐药肠杆菌科细菌 乙二胺四乙酸改良碳青霉烯灭活试验 

分 类 号：R446.5[医药卫生—诊断学]