[1]尚佳文,徐文娜,许南松,等.mCIM 和碳青霉烯酶抑制剂增强试验检测CRE 和CRPA 产酶表型的方法学评价[J].现代检验医学杂志,2023,38(03):165-169.[doi:10.3969/j.issn.1671-7414.2023.03.030]
　SHANG Jia-wen,XU Wen-na,XU Nan-song,et al.Methodological Evaluation of mCIM and Carbapenemase Inhibitor-enhancing Assays to Detect CRE and CRPA Enzyme Producing Phenotypes[J].Journal of Modern Laboratory Medicine,2023,38(03):165-169.[doi:10.3969/j.issn.1671-7414.2023.03.030]
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mCIM 和碳青霉烯酶抑制剂增强试验检测CRE 和CRPA 产酶表型的方法学评价()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年03期
页码:
165-169
栏目:
研究简报·实验技术
出版日期:
2023-05-15

文章信息/Info

Title:
Methodological Evaluation of mCIM and Carbapenemase Inhibitor-enhancing Assays to Detect CRE and CRPA Enzyme Producing Phenotypes
文章编号:
1671-7414（2023）03-165-05
作者:
尚佳文1; 徐文娜2; 许南松2; 刘晓敏2; 曾秋耀2; 郑 炘2
（1. 广东医科大学医学技术学院，广东东莞 523808；2. 中山大学肿瘤防治中心检验科，华南肿瘤学国家重点实验室肿瘤医学协同创新中心，广州 510060）
Author(s):
SHANG Jia-wen1;  XU Wen-na2;  XU Nan-song2;  LIU Xiao-min2;  ZENG Qiu-yao2;  ZHENG Xin2
（1.College of Medical Technology, Guangdong Medical University, Guangdong Dongguan 523808, China; 2.Department of Clinical Laboratory, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center o
关键词:
肠杆菌目; 铜绿假单胞菌; 改良碳青霉烯酶灭活试验; 碳青霉烯酶抑制剂增强试验; 胶体金法
分类号:
R446.5
DOI:
10.3969/j.issn.1671-7414.2023.03.030
文献标志码:
A
摘要:
目的 综合评估改良碳青霉烯酶灭活试验（mCIM）和碳青霉烯酶抑制剂增强试验对碳青霉烯酶检测和分型能力。方法 采用mCIM 和碳青霉烯酶抑制剂增强试验检测中山大学肿瘤防治中心2019 ～ 2022 年临床分离并保存的47 株耐碳青霉烯类肠杆菌目细菌（carbapenem-resistant Enterobacterales, CRE）和42 株耐碳青霉烯类铜绿假单胞菌（carbapenem-resistant Pseudomonas aeruginosa, CRPA）的产酶表型，胶体金法对检测结果进行验证比对，通过卡方检验进行统计分析，并从多角度综合评价。结果 mCIM 检测CRE 和CRPA 的阳性率分别为70.2% 和35.7%，碳青霉烯酶不确定占比为25.5% 和11.9%。增强试验检测47 株CRE：44.7% 产B 类金属β 内酰胺酶，17.0% 产A 类碳青霉烯酶，不产A 或B 类碳青霉烯酶的菌株占38.3%；增强试验检测42 株CRPA：2.4% 产B 类金属β 内酰胺酶，90.4% 产A 类碳青霉烯酶，同时产A 类碳青霉烯酶和B 类金属β- 内酰胺酶的菌株占4.8%，不产A 或B 类碳青霉烯酶的菌株占2.4%。两种方法检测CRE 差异有统计学意义（χ2=17.803，P =0.01），检测CRPA 差异无统计学意义（χ2=4.632，P=0.592）。胶体金法验证：产碳青霉烯酶的阳性符合率为84.6%，产丝氨酸酶的阳性符合率为80%，产金属酶的阳性符合率为100%。结论 检测CRE两种方法均适用且差异不大， CRPA更推荐碳青霉烯酶抑制剂增强试验，胶体金值得推广，临床实验室应根据实际条件选择检测方法。
Abstract:
Objective To comprehensively evaluate the ability of modified carbapenemase inactivation test (mCIM) and carbapenemase inhibitor enhancement test for carbapenemase detection and typing. Methods mCIM and carbapenemase inhibitor enhancement test were used to detect 47 strains of carbapenem-resistant Enterobacterales (CRE) and 42 strains of carbapenem-resistant Pseudomonas aeruginosa (CRPA), which isolated and stored in Sun Yat-sen University Cancer Center from 2019 to 2022, the detection results were verified by colloidal gold method, statistical analysis was performed by chi-square test, and comprehensive evaluation was performed from multiple angles. Results The positive rates of CRE and CRPA detected by mCIM were 70.2% and 35.7%, and the proportion of carbapenemase uncertainty was 25.5% and 11.9%. The results of enhanced test showed that 44.7% of the CRE strains produced class B metallo-β-lactamases, 17.0% produced class A carbapenemases, and 38.3% did not produce class A or B carbapenemases. The results of enhanced test showed that 2.4% of the CRPA strains produced class B metallo-β-lactamases, 90.4% produced class A carbapenemases, 4.8% produced both class A carbapenemases and class B metallo-β-lactamases, and 2.4% did not produce class A or B carbapenemases. There was significant difference in CRE detection between the two methods (χ2=17.803，P=0.01), but no significant difference in CRPA detection between the two methods (χ2=4.632, P=0.592). The results were verified by colloidal gold method: the positive coincidence rate of carbapenemase production was 84.6%, the positive coincidence rate of serine enzyme production was 80%, and the positive coincidence rate of metalloenzyme production was 100%. Conclusion The two methods of CRE detection were applicable and there was no significant difference. Carbapenemase inhibitor enhanced test is more recommended for CRPA detection, colloidal gold is worth promoting, clinical laboratories should choose the detection methods according to the actual conditions.

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备注/Memo

备注/Memo:
作者简介：尚佳文（2000-），女，硕士，研究方向：医学检验技术。
通讯作者：郑炘（1984-），男，硕士，副主任技师，研究方向：肠杆菌目细菌碳青霉烯耐药机制研究，E-mail:jiawenzx_2022@163.com。
更新日期/Last Update: 2023-05-15