[1]白　倩,赵　雅,王　林.临床克雷伯菌属碳青霉烯酶三种检测方法的实验比较研究[J].现代检验医学杂志,2022,37(01):149-153.[doi:10.3969/j.issn.1671-7414.2022.01.030]
　BAI Qian,ZHAO Ya,WANG Lin,et al.Comparative Study on Three Detection Methods of Clinical Carbapenemase Producing Klebsiella[J].Journal of Modern Laboratory Medicine,2022,37(01):149-153.[doi:10.3969/j.issn.1671-7414.2022.01.030]
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临床克雷伯菌属碳青霉烯酶三种检测方法的实验比较研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第37卷
期数:
2022年01期
页码:
149-153
栏目:
论　著
出版日期:
2022-01-15

文章信息/Info

Title:
Comparative Study on Three Detection Methods of Clinical Carbapenemase Producing Klebsiella
文章编号:
1671-7414（2022）01-149-06
作者:
白　倩1; 赵　雅1; 2; 王　林2
（1. 陕西中医药大学，陕西咸阳 712046；2. 西安市第一医院检验科，西安 710002）
Author(s):
BAI Qian1; ZHAO Ya1;  2; WANG Lin2
（1. Shaanxi University of Traditional Chinese Medicine，Shaanxi Xianyang710046, China; 2. Department of Clinical Laboratory, Xi’an First Hospital,Xi’an 710002，China）
关键词:
碳青霉烯酶; 聚合式酶链反应; 改良碳青霉烯酶灭活试验; EDTA碳青霉烯酶灭活试验; GeneXpert
分类号:
R378.996；R446.5
DOI:
10.3969/j.issn.1671-7414.2022.01.030
文献标志码:
A
摘要:
目的　对聚合式酶链反应（ polymerase chain reaction，PCR）、改良碳青霉烯酶灭活试验（ modi.ed carbapenem inactivation method,mCIM）+ EDTA碳青霉烯酶灭活试验（ EDTA-carbapenem inactivation method, eCIM）和 GeneXpert三种方法检测碳青霉烯酶的性能进行了比较，为临床选择合适的检测方法提供依据。方法　收集 2019年 1月～ 2021年 5月临床分离的 43株碳青霉烯类抗生素耐药及 37株碳青霉烯类抗生素敏感克雷伯菌属菌株，用 PCR法和 GeneXpert试验检测碳青霉烯酶基因， mCIM+ eCIM试验检测碳青霉烯酶。以 PCR法为金标准，对三种试验方法检测结果进行比较。结果　43株耐碳青霉烯克雷伯菌属经 PCR扩增检测有 40株携带碳青霉烯耐药基因， blaKPC 30株，blaNDM 8株， blaIMP 2株；37株碳青霉烯类敏感克雷伯菌属经 PCR扩增均未检出碳青霉烯酶基因。与 PCR法结果相比， mCIM+eCIM试验检测丝氨酸酶及金属酶表型结果敏感度和特异度均为 100%，Kappa值为 1；GeneXpert技术敏感度和特异度分别为
Abstract:
Objective　To provide a basis for clinical selection of appropriate detection methods of carbapenemases, comparedthe difference of three clinical methods, including polymerase chain reaction (PCR), modified carbapenem inactivation method(mCIM) + EDTA synergistic carbapenem inactivation method (eCIM) and GeneXpert, and evaluated their performance. Methods　Collected 43 carbapenem antibiotic-resistant Klebsiella strains and 13 carbapenem antibiotic-sensitive Klebsiella strains werecollected from January 2019 to May 2021. PCR and GeneXpert test were used to detect carbapenemase gene, and mCIM+eCIMtest was used to detect carbapenemase. The PCR method was used as the gold standard to compare the detection results of thethree test methods. Results　40 out of 43 carbapenem-resistant Klebsiella carried carbapenem resistance genes detected by PCR,including 30 blaKPC, 8 blaNDM, and 2 blaIMP．None of the 37 carbapenem-sensitive Klebsiella strains detected the carbapenemasegene by PCR. The sensitivity and specificity of the serinase and metalloenzyme phenotypes detected by mCIM+eCIM test were100%, and the Kappa value was 1. The sensitivity and specificity of GeneXpert technology were 94.9% and 97.6%, respectively,and the Kappa value was 0.925. Conclusion　Both the mCIM+ eCIM test and GeneXpert have a strong agreement with PCRresults. Considering effectiveness, GeneXpert is simple to operate, easy to interpret, time-consuming, accurate, and reliable. It issuitable for routine development in clinical microbiology laboratories.

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备注/Memo

备注/Memo:
基金项目：陕西省科技厅基金资助项目（编号：2017SF-119）。
作者简介：白倩（1997-），女，硕士研究生，检验技师，从事临床微生物耐药机制研究，E-mail：1377783840@qq.com。
通讯作者： 赵雅（1964-），女，主任检验师，研究生导师，从事临床微生物耐药机制研究及分子生物学研究技术，E-mail：zhaoya2508@sina. com。
更新日期/Last Update: 1900-01-01