改良碳青霉烯灭活法和EDTA双纸片增效法检测产碳青霉烯酶铜绿假单胞菌耐药表型的分析  

Detection of carbapenem resistant phenotype of Pseudomonas aeruginosa by modified carbapenem inactivation method and EDTA double disk synergistic method

作　　者：闫津津[1] 杨会林[1] 廖娟娟 陈娟[1] 周丽娜 YAN Jinjin;YANG Huilin;LIAO Juanjuan;CHEN Juan;ZHOU Lina(Laboratory Department of Peking University Shenzhen Hospital,Shenzhen,Guangdong 518000,China)

机构地区：[1]北京大学深圳医院检验科,广东深圳518000

出　　处：《国际检验医学杂志》2022年第S01期50-55,共6页International Journal of Laboratory Medicine

摘　　要：目的 通过改良碳青霉烯灭活法(mCIM)检测产碳青霉酶铜绿假单胞菌的耐药表型,评估EDTA双纸片增效法检测产碳青霉烯酶铜绿假单胞菌的分型,为临床选择合理抗菌药物提供依据。方法 收集2020年1-12月北京该院临床标本分离的铜绿假单胞菌626株,筛选耐碳青霉烯类铜绿假单胞菌35株,分别采用改良碳青霉烯灭活法和EDTA双纸片增效法检测碳青霉烯酶耐药表型,采用聚合酶链反应技术(PCR)进行铜绿假单胞菌常见耐药基因分析。结果 mCIM试验中,6株检出碳青霉烯酶,5株为结果不确定;EDTA双纸片增效法中,7株产丝氨酸型碳青霉烯酶,2株产金属型碳青霉烯酶,1株为同时产丝氨酸型和金属型碳青霉烯酶,1株阴性;PCR法中,PDC、OprD2基因阳性率较高,IMP-9、Intl1阳性率较低,三株产金属型碳青霉烯酶铜绿假单胞菌均检出IMP-9耐药基因。结论 改良碳青霉烯灭活法结合EDTA双纸片增效法可用于实验室初筛产碳青霉烯酶铜绿假单胞菌的耐药表型。Objective The carbapenemase-producing Pseudomonas aeruginosa was detected by mCIM and the EDTA double disc synergistic method,both of which could detect the resistant phenotype of the carbapenemase-producing Pseudomonas aeruginosa,as to preliminarily distinguish the types of Pseudomonas aeruginosa producing carbapenemase,further in order to provide a basis of rational selection of antibacterial drugs in clinical practice.Methods Collected 626 Pseudomonas aeruginosa strains isolated from clinical specimens of Peking University Shenzhen Hospital from January to December 2020,From 626 strains,selected 35 strains of Pseudomonas aeruginosa which resistant to carbapenem antibiotics,mCIM and EDTA double disc synergy method were used to detect carbapenemase-resistant phenotypes,meanwhile uses polymerase chain reaction(PCR)to analyze Pseudomonas aeruginosa's resistant genes.Results 6 strains were positive to carbapenemase,and 5 strains were uncertain results in the mCIM test;In the EDTA double-disk synergistic method,7 strains produce serine carbapenemase,2 strains produce metal carbapenemase,1 strain produces both serine and metal carbapenemase,and 1 strain was negative;In the PCR method,the positive rates of PDC and OprD2 genes were the highest two of all,IMP-9 and Intl1 genes were lower than PDC and OprD2,and the genes of DHA,IMP-1 and VIM-2 were negative.Conclusion The mCIM method which combined the EDTA double-disc synergistic method can be used to screen the resistant phenotype of Pseudomonas aeruginosa producing carbapenemase in the laboratory.

关 键 词：耐碳青霉烯类铜绿假单胞菌 碳青霉烯酶 mCIM EDTA双纸片增效法 

分 类 号：R44[医药卫生—诊断学]