评价自建立飞行质谱仪检测肺炎克雷伯菌对亚胺培南耐药性的方法价值的研究  

Evaluate the Value of Self-established MADLI-TOF-MS for Detecting Imipenem Resistance of Klebsiella pneumonia

作　　者：蔡淑梅 张子馨 陈娟 陈坤 金秀秀 Cai Shu-mei;Zhang Zi-xin;Chen Juan;Chen Kun;Jin Xiu-xiu(Fujian Key Laboratory of Aptamers Technology,Department of Clinical Laboratory Medicine,Fuzhou General Clinical Medical School(the 900th Hospital),Fuzhou 350025;Faculty of Medical Technology and Engineering,Fuzhou 350122)

机构地区：[1]中国人民解放军联勤保障部队第九〇〇医院,福建省适配体技术重点实验室,福州350025 [2]福建医科大学医学技术与工程学院,福州350122

出　　处：《国外医药（抗生素分册）》2022年第2期101-104,共4页World Notes on Antibiotics

基　　金：临床医学研究专项,编号:2020L17。

摘　　要：目的利用肺炎克雷伯菌对亚胺培南的水解能力,采用飞行时间质谱检测肺炎克雷伯菌对亚胺培南的耐药性、建立一种可以快速、准确检测肺炎克雷伯菌对亚胺培南耐药性方法、评价自建立方法的检测能力。方法通过实验探寻本实验室合适的亚胺培南浓度、孵育时间以及温度,再利用检测肺炎克雷伯菌对亚胺培南的水解能力,建立飞行时间质谱检测肺炎克雷伯菌对亚胺培南的水解能力方法。在此基础上,收集临床肺炎克雷伯菌株40株,进行双盲随机编码,利用自建立的方法检测其肺炎克雷伯菌株水解亚胺培南能力。将结果和MIC法结果进行比对,从而评价自建立的方法检测敏感性和特异性。结果在亚胺培南水解实验中,亚胺培南浓度为1mg/mL,菌悬液比浊度为1McF,37℃条件下孵育60min,有部分待测菌的亚胺培南质谱峰明显下降(纵坐标:绝对强度70%以上);在37℃条件下孵育120min,产碳青霉烯酶菌株的亚胺培南质谱峰均有明显下降(纵坐标:绝对强度70%以上)。亚胺培南浓度为1mg/mL,菌悬液比浊度为1McF,37℃条件下孵育120min下检测结果与MIC法结果进行比对,自建立的方法检测的敏感性和特异性分别为:82.76%,81.82%。结论飞行时间质谱可以快速、准确检测肺炎克雷伯菌对亚胺培南耐药性,自建立的方法检测具有较高敏感性和特异性较高,可适用于临床筛选肺炎克雷伯菌对亚胺培南耐药性,指导临床合理用药,早期治疗,控制耐碳青霉烯肺炎克雷伯菌传播扩散。Objective According to the hydrolysis imipenem ability of Klebsiella pneumoniae,established a rapid and accurate method to detect the imipenem resistance of Klebsiella pneumoniae by MADLI-TOF-MS to evaluate the value of self-established MADLI-TOF-MS for detecting imipenem resistance of Klebsiella pneumonia.Methods Suitable imipenem concentration,incubation time and temperature were explored through experiments,and then establish the detection the ability for the hydrolysis imipenem by Klebsiella pneumoniae.Then we tested the hydrolysis imipenem of 40 Klebsiella pneumoniae strains with the method.The results to sensitivity and specificity of the self-established method,were compared with those of MIC method (WalkAway 96 Plus)..Results The concentration of imipenem was 1mg/mL,the specific turbidity of bacterial suspension was 1 mcf,and the medium was incubated at 37℃ for 60min,the mass spectral peaks of imipenem of some tested bacteria were decreased significantly (more than 70%).After incubation at 37℃ for 120min,the imipenem mass spectrum of the carbapenemase-producing strain was significantly decreased (more than 70%).The sensitivity and specificity of the self-established method (incubation 120min) were 82.76% and 81.82% respectively,which was compared with MIC method.Conclusion The self-established MADLI-TOF-MS for detecting imipenem resistance of Klebsiella pneumonia,which can rapid and accurate identification to the imipenem resistance of Klebsiella pneumoniae,have a high sensitivity and specificity.It is suitable to screen the imipenem resistance of Klebsiella pneumoniae and guide clinical rational drug use,early treatment and control the spread of carbapenem-resistant Klebsiella pneumoniae.

关 键 词：肺炎克雷伯菌 亚胺培南 飞行时间质谱 

分 类 号：R978.1[医药卫生—药品]