免疫层析技术在肠杆菌目细菌产碳青霉烯酶快速检测中的应用  

Utility of immunochromatography in rapid detection of carbapenemases produced by Enterobacterales strains

作　　者：韩仁如 潘芬 尹丹丹 丁丽 郭燕 吴湜 杨洋 于方圆 蒋婕[2] 石迎迎 胡付品 张泓[2] HAN Renru;PAN Fen;YIN Danan;DING Li;GUO Yan;WU Shi;YANG Yang;YU Fangyuan;JIANG Jie;SHI Yingying;HU Fupin;ZHANG Hong(Institute of Antibiotics,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院抗生素研究所,上海200040 [2]上海市儿童医院,上海交通大学医学院附属儿童医院检验科

出　　处：《中国感染与化疗杂志》2024年第6期658-663,共6页Chinese Journal of Infection and Chemotherapy

摘　　要：目的比较两种免疫层析技术在快速检测碳青霉烯类耐药肠杆菌目细菌(CRE)产碳青霉烯酶中的应用价值。方法收集390株临床分离的肠杆菌目细菌,以聚合酶链反应(PCR)方法作为金标准,采用两种免疫层析法同步进行CRE菌株的碳青霉烯酶基因型检测。结果采用碳青霉烯酶的表型检测390株临床分离肠杆菌目细菌,213株为CRE菌株,177株为碳青霉烯类敏感肠杆菌目细菌(CSE)菌株。经PCR基因型检测,213株CRE菌株中,207株产碳青霉烯酶,6株CRE菌株碳青霉烯类耐药机制不明确;207株产碳青霉烯酶菌株中,119株产KPC酶、71株产NDM酶、9株产IMP酶、7株产OXA-48-like酶和1株复合酶(KPC酶+NDM酶)。同步采用两种免疫层析法(丹娜DMK和NG-Test®CARBA5)进行检测,检测与PCR结果符合率均为100%。两种免疫层析法检测5种碳青霉烯酶的灵敏度均为100%(95%CI:97.7%~100%),特异度均为100%(95%CI:97.4%~100%)。结论免疫层析法操作简便、快速,可应用于检测临床分离的碳青霉烯类耐药菌株产碳青霉烯酶的分型。Objective To evaluate the performance of two immunochromatography kits(lateral flow immunoassay)in detecting carbapenemases in carbapenem-resistant Enterobacterales(CRE).Methods A total of 390 nonduplicate clinical isolates of Enterobacterales were collected and tested.The carbapenemase gene was identified by polymerase chain reaction(PCR).The five common carbapenemases were tested by two immunochromatography kits.Results Overall,213 of the 390 Enterobacterales isolates were CRE and 177 strains were carbapenem-susceptible based on antimicrobial susceptibility testing.PCR assay confirmed that 207 of the 213 CRE strains carried carbapenemase genes,including KPC genotype in 119 strains,NDM genotype in 71 strains,IMP genotype in 9 strains,OXA-48-like genotype in 7 strains,both KPC and NDM genes in 1 strain,while none of the five common carbapenemases in 6 CRE strains.Two immunochromatography kits were used simultaneously to test the production of carbapenemases.The results of the two commercial kits were 100%consistent with PCR results.The sensitivity and specificity of the two kits were 100%(95%CI,97.7%-100%)and 100%(95%CI,97.4%-100%)in detection of the five carbapenemases.Conclusions The immunochromatography method is rapid and easy to operate,and can be used to detect the production of carbapenmases in clinical isolates.

关 键 词：碳青霉烯类耐药肠杆菌目细菌 碳青霉烯酶 免疫层析技术 

分 类 号：R378.2[医药卫生—病原生物学]