我院耐碳青霉烯类肠杆菌科细菌碳青霉烯酶不同检测方法的比较  

A Comparative Study of Different Detection Methods of Carbapenem Resistant Enterobacteriaceae in Our Hospital

作　　者：高翔[1] 赵硕 黄晓霞 田敬华[1] GAO Xiang;ZHAO Shuo;HUANG Xiaoxia;TIAN Jinghua(Department of Clinical Laboratory,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院检验科,北京100010

出　　处：《标记免疫分析与临床》2023年第1期133-139,共7页Labeled Immunoassays and Clinical Medicine

基　　金：北京市财政项目(编号:PXM2020_026273_000001)。

摘　　要：目的探讨评价碳青霉烯酶的不同检测方法,为实验室检测及临床诊疗提供依据。方法选用EDTA碳青霉烯灭活方法(mCIM/eCIM)检测耐碳青霉烯类肠杆菌(carbapenem-resistant Enterobacteriaceae,CRE)菌株耐药表型,以两种免疫层析碳青霉烯酶检测试剂盒、荧光定量PCR法检测CRE菌株基因型。统计学方法采用Kappa一致性检验,比较各种检测方法的临床可操作性。结果经荧光定量PCR扩增后基因测序显示73株肺炎克雷伯菌中71株携带KPC基因,2株携带NDM基因;7株大肠埃希菌中6株携带NDM基因,1株携带KPC基因;mCIM联合eCIM检测KPC的灵敏度为68.1%(49/72),检测NDM的灵敏度为100.0%(8/8);NG-test Carba 5和免疫显色试剂盒检测KPC和NDM灵敏度为100.0%、特异性为100.0%。结论NG-test Carba 5和免疫显色试剂盒检测可以成为检测我国最常见碳青霉烯酶的快速、方便的诊断工具,从而有助于控制产碳青霉烯酶的分离株在医院间的传播,为院感防控工作起到至关重要的意义。Objective To investigate different detection methods for evaluating carbapenemase,and to provide a reference for laboratory detection and clinical diagnosis and treatment.Methods EDTA carbapenem inactivation method(mCIM/eCIM)was used to detect the drug resistance phenotype of carbapenem-resistant Enterobacteriaceae(CRE)strains.Genotypes of CRE strains were detected by kit and fluorescence quantitative PCR method.Kappa consistency test was applied to compare the clinical operability of various detection methods.Results Gene sequencing after amplification by fluorescence quantitative PCR showed that 71 of the 73 Klebsiella pneumoniae strains carried KPC gene and 2 strains carried NDM gene;6 of the 7 Escherichia coli strains carried NDM gene and 1 strain carried KPC gene;The sensitivity of mCIM combined with eCIM for detecting KPC was 68.1%(49/72),and the sensitivity for detecting NDM was 100%(8/8);NG-test Carba 5 and immunochromogenic kits achieved 100%sensitivity and 100%specificity for detecting KPC and NDM.Conclusion NG-test Carba 5 and immunochromogenic kits can serve as a rapid and convenient diagnostic tool for the detection of the most common carbapenemases in our country,thereby improving the control of the prevalence of carbapenemase-producing isolates in hospitals.Dissemination can play a vital role in the prevention and control of hospital infection.

关 键 词：碳青霉烯酶 荧光定量PCR EDTA碳青霉烯灭活方法(mCIM/eCIM) NG-test Carba 5 

分 类 号：R378[医药卫生—病原生物学]