iCubate-iC血培养快速检测系统与血培养传统鉴定药敏一致性评估  

Consistency assessment between iCubate⁃iC blood culture rapid detection system and traditional blood culture identification of drug susceptibility

作　　者：刘振嘉[1] 范欣 毛熠 张丹 杨春霞[1] LIU Zhenjia;FAN Xin;MAO Yi;ZHANG Dan;YANG Chunxia(Department of Infectious Diseases and Clinical Microbiology,Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital,Capital Medical University,Beijing,China,100020)

机构地区：[1]首都医科大学附属北京朝阳医院-北京市呼吸疾病研究所感染和临床微生物科,北京100020

出　　处：《分子诊断与治疗杂志》2024年第5期949-952,957,共5页Journal of Molecular Diagnostics and Therapy

摘　　要：目的评估基于PCR扩增荧光探针捕获技术的iCubate-iC血培养快速检测系统与血培养传统鉴定药敏结果的一致性。方法本次评估入组了首都医科大学附属北京朝阳医院2017年11月26日至2018年4月18日的121例临床血液细菌培养阳性标本。以临床常规培养鉴定结果及体外药敏结果为参考方法,验证iCubate-iC系统鉴定结果及耐药位点检出的一致性。结果对比MALDI-TOF质谱鉴定结果,iCubate-iC系统鉴定符合率达到95.9%(116/121)。有4例假阴性结果,所有靶标显示“未检出”。iCubate-iC系统成功检出1例金黄色葡萄球菌和表皮葡萄球菌的混合样本,而1例大肠埃希菌和铜绿假单胞菌复合样本漏检了铜绿假单胞菌。iC-GPC检出的31例葡萄球菌中,有18例检出了mecA基因,其中有1例表皮葡萄球菌检出mecA,但其体外药敏结果显示对头孢西丁敏感。肠球菌中有1例检出vanA基因,但万古霉素体外药敏检测敏感。CTX-M group1基因检测与β内酰胺类药物的吻合性不理想,但革兰氏阴性菌碳青霉烯酶基因(KPC、NDM)检测结果与碳青霉烯类药物的药敏结果能够完全吻合。结论iCubate-iC检测系统对于临床常见引起血流感染细菌的检测结果可靠,且具有快速简便的优点,为引起血流感染细菌的快速诊断提供了有力工具。Objective To evaluate consistency of blood culture traditional identification and anti⁃microbial susceptibility with a PCR amplification/fluorescence⁃labeled probe capture⁃based system,the iCu⁃bate⁃iC assay,for rapid detection of blood culture positive specimens.Methods A total of 121 clinical blood culture positive specimens from November 26,2017 to April 18,2018 were enrolled in this study.The consis⁃tency of the identification and resistance marker detection of the iCubate⁃iC system was evaluated against clini⁃cal routine culture identification and in vitro antimicrobial susceptibility results.Results The identification of 95.9%(116/121)samples using iCubate⁃iC assay agreed with the results of MALDI⁃TOF MS.There were four false negative results,all of which showed“not detected”for the corresponding iCubate⁃iC target probes.It is worth noting that a specimen containing both Staphylococcus aureus and S.epidermidis was correctly detected by the iCubate⁃iC assay.In composite samples of Escherichia coli and Pseudomonas aeruginosa,was not de⁃tected Among 31 staphylococci isolates,18 were positive for mecA by iC⁃GPC.However,one S.epidermidis isolate was susceptible to cefoxitin in vitro.Only one enterococci isolate was positive for vanA,but it was sus⁃ceptible to vancomycin in vitro.Results for detecting carbapenemase⁃encoding genes(such as KPC and NDM)were consistent with in vitro antimicrobial susceptibility testing.The consistency between ESBL gene(CTX⁃M group1)andβlactam drugs in vitro was unsatisfactory,but the results for detecting carbapenemase⁃encoding genes(KPC and NDM)were consistent with in vitro antimicrobial susceptibility testing.Conclusion The iCu⁃bate⁃iC system is reliable for detecting common bloodstream infection bacteria in clinical settings.It offers the advantages of being rapid and simple,making it a powerful tool for quickly diagnosing bloodstream infections.

关 键 词：血流感染 血培养 快速鉴定 耐药基因 

分 类 号：R446.5[医药卫生—诊断学]