耐碳青霉烯肺炎克雷伯菌对替加环素敏感性及不同检测方法的差异性研究  

Study on in vitro sensitivity of tigacycline to carbapenem-resistant Klebsiella pneμmoniae and detection difference by different detection methods

作　　者：卢雯君[1] 李情操[2] 裘雪丹 吴巧萍[2] 易泽源 LU Wen-jun;LI Qing-cao;QIU Xue-dan;WU Qiao-ping;YI Ze-yuan(ICU,Ningbo Medical Center Lihuili Hospital,Ningbo,Zhejiang 315040,China;不详)

机构地区：[1]宁波市医疗中心李惠利医院ICU,浙江宁波315040 [2]宁波市医疗中心李惠利医院检验科,浙江宁波315040

出　　处：《中国卫生检验杂志》2022年第6期668-671,共4页Chinese Journal of Health Laboratory Technology

基　　金：浙江省医药卫生科技项目(2021KY1031)。

摘　　要：目的了解碳青霉烯类抗生素耐药肺炎克雷伯菌(CRKP)的体外对于替加环素敏感性,以及不同药敏检测方法之间存在的差异。方法选择临床分离的耐碳青霉烯肺炎克雷伯菌147株,分别采用肉汤稀释法、Etest纸片法、仪器法(N334药敏卡)、纸片法(K-B)和药敏纸片联合复敏液法检测其体外对替加环素的敏感性,分析5种药敏检测方法所存在的差异。结果147株耐碳青霉烯类肺炎克雷伯菌微量肉汤稀释法、Etest法、仪器法、KB法和KB联合复敏液法的敏感率分别为98.6%、100.0%、71.4%、49.7%和95.2%,其中Etest法和KB联合复敏液法与参考方法具有较高一致性,而仪器法和KB法敏感率显著下降(P<0.01);4种方法的误差分析表明,Etest法和KB联合复敏液法符合率较高。仪器法标准符合(CA)、重大错误(ME)和小错误(mE)分别为71.43%、9.52%和19.05%,KB法CA和ME分别为49.66%和48.98%,均超出标准。结论本地区CRKP菌株对于替加环素具有较高敏感性,Etest和KB联合复敏液法相对参考方法具有较高一致性和准确性,适合在临床实验室推广。Objective To understand the in vitro sensitivity of tigacycline to carbapenem resistant Klebsiella pneμmoniae(CRKP),and the differences in drug sensitivity of tigacycline detected by different methods.Methods A total of 147 clinically isolated CRKP were selected for in vitro sensitivity to tegecycline by broth dilution method,Etest slip method,instrument method,paper(K-B)and drug susceptibility paper joint re-sensitive liquid method,and the differences in the five drug sensitivity detection methods were analyzed.Results The sensitivity of 147 CRKP by microbroth dilution,Etest,instrument,KB and KB combined re-sensitive liquid were 98.6%,100.0%,71.4%,49.7%and 95.2%,respectively,with the Etest and KB combined re-sensitive liquid methods having high agreement with the reference methods,while instrument and KB methods decreased significantly(P<0.01).Error analysis of the four methods showed that the Etest and KB combined re-sensitive liquid methods have high compliance rate.The compliance(CA),major error(ME)and minor error(mE)of instrument method were 71.43%,9.52%and 19.05%,respectively,and the CA and ME of KB method were 49.66%and48.98%,respectively.Conclusion The CRKP strains in this region have high sensitivity to teticacycline,and the high consistency and accuracy are suitable for the promotion in clinical laboratories.

关 键 词：碳青霉烯类抗生素耐药肺炎克雷伯菌 替加环素 肉汤稀释法 仪器法 纸片法 复敏液 敏感性差异 

分 类 号：R446.5[医药卫生—诊断学]