GICA在检测CRE引起的血流感染早期中的应用价值研究  

Application value of GICA in detecting early blood flow infections caused by CRE

作　　者：韩云港 王伟[2] 臧文巧[1] HAN Yungang;WANG Wei;ZANG Wenqiao(School of Basic Medical Sciences,Zhengzhou University,Zhengzhou,Henan 450001,China;Henan Provincial Chest Hospital/Chest Hospital of Zhengzhou University,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州大学基础医学院,河南郑州450001 [2]河南省胸科医院/郑州大学附属胸科医院,河南郑州450000

出　　处：《现代医药卫生》2024年第10期1632-1636,共5页Journal of Modern Medicine & Health

基　　金：河南省医学科技攻关计划项目(LHGJ20190759)。

摘　　要：目的评估胶体金免疫色谱技术(GICA)在检测碳青霉烯类耐药肠杆菌目细菌(CRE)引起的血流感染早期中的应用价值,为临床CRE感染精准治疗提供实验室依据。方法收集2020年1-12月河南省胸科医院住院患者中31份CRE标本和20份碳青霉烯类敏感肠杆菌目细菌标本,建立模拟血培养阳性实验方案,利用GICA对51份血培养阳性产物经预处理直接检测碳青霉烯酶,以聚合酶链反应测序结果作为“金标准”,评估GICA在直接检测阳性血培养标本中碳青霉烯酶分型的准确性。结果51份血培养阳性标本中聚合酶链反应测序结果中有13株携带bla_(KPC-2)基因,14株携带bla_(NDM-1)基因,2株携带bla_(NDM-5)基因,2株同时携带bla_(KPC-2)和bla_(NDM-1)基因,其余20株均未检测到相应的耐药基因。GICA检测出的31份产生碳青霉烯酶的标本中13株产生bla_(KPC)酶,16株产生bla_(NDM)酶,有2株同时产生bla_(KPC)和bla_(NDM)酶。2种方法检测碳青霉烯酶分型结果一致(Kappa=1),灵敏度、特异度均为100%。结论GICA具有操作方便和耗时短等优点,同时,具有较高的灵敏度和特异度,可显著缩短血流感染CRE的诊断时间,可在早期为临床医生提供合理用药的实验依据。Objective To evaluate the application value of gold immunochromatographic assay(GICA)in the detection of carbapenem resistant enterobacteriaceae(CRE)in the early stage of bloodstream infection,and provide laboratory basis for the precise treatment of CRE infection.Methods A total of 31 CRE samples and 20 carbapenem-sensitive enterobacteriaceae samples were collected from inpatients in Henan Provincial Chest Hospital from January to December 2020,and a simulated blood culture positive experimental scheme was established.A total of 51 positive blood culture products were pretreated by GICA to directly detect carbapenemase,and the results of polymerase chain reaction sequencing were used as“the gold standard”to evaluate the accuracy of GICA in directly detecting carbapenemase typing in positive blood culture samples.Results The positive results of 51 blood cultures showed that 13 strains carried bla_(KPC-2) genotype,14 strains carried bla_(NDM-1) genotype,two strains carried bla_(NDM-5) genotype,and two strains carried both bla KPC-2 and bla_(NDM-1) genotypes.No corresponding drug resistance genes were detected in the remaining 20 strains.The 31 carbapenemase producing samples were detected by colloidal gold immunochromatography,of which 13 strains produced bla_(KPC),16 strains produced bla_(NDM),and two strains produced bla_(KPC) and bla_(NDM) at the same time.The results of the two methods were consistent(Kappa=1),and the sensitivity and specificity were 100%.Conclusion GICA has the advantages of convenient operation,short time consumption,high sensitivity and specificity.This method can significantly shorten the diagnosis time of CRE in bloodstream infection,and provide experimental basis for rational drug use for clinicians in the early stage.

关 键 词：碳青霉烯类耐药肠杆菌目细菌 胶体金免疫色谱技术 碳青霉烯酶 血流感染 应用价值 

分 类 号：R63[医药卫生—外科学] R446.6[医药卫生—临床医学]