[1]王 颖,陈芳芳,黄 梅,等.VITEK 2 Compact专家系统对肠杆菌科碳青霉烯酶耐药表型分析的问题探讨[J].现代检验医学杂志,2017,32(04):101-103,106.[doi:10.3969/j.issn.1671-7414.2017.04.028]
　WANG Ying,CHEN Fang-fang,HUANG Mei,et al.Discussion on the Problems of Vitek 2 Compact Advanced Expert System to Identify Carbapenemase Phenotypes in Isolates of Enterobacteriaceae[J].Journal of Modern Laboratory Medicine,2017,32(04):101-103,106.[doi:10.3969/j.issn.1671-7414.2017.04.028]
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VITEK 2 Compact专家系统对肠杆菌科碳青霉烯酶耐药表型分析的问题探讨()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第32卷
期数:
2017年04期
页码:
101-103,106
栏目:
论著
出版日期:
2017-07-25

文章信息/Info

Title:
Discussion on the Problems of Vitek 2 Compact Advanced Expert System to Identify Carbapenemase Phenotypes in Isolates of Enterobacteriaceae
文章编号:
1671-7414(2017)04-101-04
作者:
王 颖; 陈芳芳; 黄 梅; 奚海燕; 范 明; 邵海枫; 王卫萍
南京总医院中心实验科,南京 210002
Author(s):
WANG Ying; CHEN Fang-fang; HUANG Mei; XI Hai-yan; FANMing;  SHAO Hai-feng; WANG Wei-ping
Clinical Center for Laboratory Medicine, Nanjing General Hospital,PLA,Nanjing 210002,China
关键词:
专家系统;  碳青霉烯酶;  肠杆菌科
分类号:
R378.2; R446.5
DOI:
10.3969/j.issn.1671-7414.2017.04.028
文献标志码:
A
摘要:
目的 评估Vitek 2 compact专家系统(AES)对肠杆菌科细菌碳青霉烯酶耐药表型的提示和分析的准确性,探讨弥补其不足的检测方法。方法收集用Vitek 2 compact检测亚胺培南非耐药,而专家系统提示其产碳青霉烯酶的肠杆菌科细菌28株。纸片扩散法检测亚胺培南药物的敏感度; 改良Hodge试验(MHT)筛查产碳青霉烯酶菌株; EDTA双纸片协同试验检测金属β‐内酰胺酶; PCR检测细菌超广谱β‐内酰胺酶(ESBLs)和碳青霉烯酶相关耐药基因。结果 28株菌中,均扩增出ESBLs相关耐药基因,其中16株扩增出KPC基因。金属酶表型皆为阴性。以碳青霉烯酶基因检测为金标准,AES的符合率为57.1%; 纸片扩散法检测亚胺培南的符合率为100%; MHT的符合率为100%。PCR与纸片扩散法及MHT对碳青霉烯酶检测的结果一致,与AES有差异(χ2=10.08,P<0.05)。结论 AES对肠杆菌科细菌产碳青霉烯酶提示不一定全部准确,存在一定的假阳性,可以采用其他方法,如简便易行的纸片扩散法或改良Hodge试验予以复检,以提高药敏结果的可靠性。
Abstract:
Objective To explore the accuracy of Vitek 2 compact advanced expert system(AES)in indicating and analyze the carbapenemases-resisting Enterobacteriaceae phenotypes,and further investigate the methods to make up the AES.Methods 28 Enterobacteriaceaestrains with Imipenem-Nonsusceptible by Vitek 2 compact,but AES suggested allproduction of carbapenemases were isolated.And imipenem susceptibility was determined by the disk diffusion method.Modified Hodge test(MHT)and the metallo-β-lactamase was detected by the double disk synergy method.Resistance geneswere detected by the PCR amplification.Results ESBLs gene was amplified from all 28 selected strains,16 of which was detected KPC gene,and no strain of metallo-β-lactamases-producing bacteria.With carbapenemase gene detection as the gold standard,the accuracy of AES was 57.1%.Disc diffusion method detection accuracy rate of imipenem was 100%,and for 100% of MHTaccuracy.PCR amplification, MHT and the disk diffusion displayed the same result in detecting carbapenemases,but different with AES(χ2=10.08,P<0.05).Conclusion The indications of the presence of carbapenemases using AES was not completely correct with a certain false-positive,and it is necessary to take other methods,such as disk diffusion or MHT methods,and improve the reliability of medicine-sensitivity tests.

参考文献/References:

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备注/Memo

备注/Memo:
作者简介:王 颖(1984-),女,本科,主管技师,主要从事微生物检验,E-mail:wynj0216@163.com。 通讯作者:王卫萍(1966-),女,硕士,主任技师,主要从事微生物学研究,E-mail:njglyyzjw@sina.com。
更新日期/Last Update: 1900-01-01