mCIM与eCIM在产碳青霉烯酶肠杆菌科细菌表型筛查中的价值  

Efficacy evaluation and application value of screening carbapenemase in enterobacteriaceae by mCIM and eCIM

作　　者：尹娟[1] 王莹超[2] 眭阳[2] 江春 时蕴琦 朱超望[2] YIN Juan;WANG Yingchao;SUI Yang;JIANG Chun;SHI Yunqi;ZHU Chaowang(Digestive Disease and Nutrition Research Center,Suzhou Municipal Hospital,The Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou 215008,Jiangsu,China;Department of Laboratory Medicine,Suzhou Municipal Hospital,The Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou 215008,Jiangsu,China)

机构地区：[1]南京医科大学附属苏州医院苏州市立医院消化系疾病与营养研究中心,江苏苏州215008 [2]南京医科大学附属苏州医院苏州市立医院检验科,江苏苏州215008

出　　处：《检验医学》2021年第2期177-180,共4页Laboratory Medicine

基　　金：南京医科大学科技发展基金项目(NMUB2018215);苏州市立医院科研项目(SLYY2017001)。

摘　　要：目的分析改良碳青霉烯灭活试验(mCIM)与乙二胺四乙酸碳青霉烯灭活试验(eCIM)对产碳青霉烯酶肠杆菌科细菌表型筛查的效能及应用价值。方法收集碳青霉烯类耐药肠杆菌科细菌(CRE)117株(实验组)、碳青霉烯类敏感肠杆菌科细菌50株(对照组)。分别采用改良Hodge试验(MHT)、mCIM和eCIM进行表型筛查,采用聚合酶链反应(PCR)检测常见碳青霉烯耐药基因,统计表型筛查试验结果与基因检测结果的一致性。结果以PCR检测出碳青霉烯酶基因为金标准,MHT筛查碳青霉烯酶的敏感性为87.0%、特异性为100.0%,mCIM筛查碳青霉烯酶的敏感性、特异性均为100.0%,eCIM筛查金属酶的敏感性为82.4%、特异性为100.0%。结论mCIM筛查碳青霉烯酶的敏感性比MHT高,mCIM与eCIM联合检测能更有效地筛查碳青霉烯酶,且可区分碳青霉烯酶类型,从而有效指导临床用药。Objective To investigate the capacity and application value of modified carbapenem inactivation method(mCIM)and ethylene diamine tetraacetic acid-carbapenem inactivation method(eCIM)for phenotypic detection of carbapenemase-producing Enterobacteriaceae.Methods A total of 117 strains of carbapenem-resistant Enterobacteriaceae(CRE)(experimental group)and 50 strains of carbapenem-sensitive Enterobacteriaceae(control group)were collected.Phenotypic screening was performed by modified Hodge test(MHT),mCIM and eCIM in both groups,respectively.Common carbapenem-resistant genes were detected by polymerase chain reaction(PCR).The consistency of phenotypic screening and gene examinations was analyzed statistically.Results When the detection result of carbapenem-resistant genes was taken as golden standard,the sensitivity of MHT for screening carbapenemase was 87.0%,and the specificity was 100.0%;both sensitivity and specificity of mCIM were 100.0%;the sensitivity and specificity of eCIM were 82.4%and 100.0%respectively.Conclusion mCIM is more sensitive than MHT in screening carbapenemase.The combined detection of mCIM and eCIM can effectively detect carbapenemase and distinguish the type of carbapenemase,which can play a guiding role in clinical medication.

关 键 词：碳青霉烯类耐药肠杆菌科细菌 碳青霉烯酶 改良HODGE试验 改良碳青霉烯灭活试验 乙二胺四乙酸碳青霉烯灭活试验 

分 类 号：R378.2[医药卫生—病原生物学]