【摘要】 目的比较3种常见的检测碳青霉烯酶筛查方法,对临床实验室选择检测方法提供依据。方法以实验室保存的109株碳青霉烯类耐药肠杆菌科细菌为研究对象,以PCR法为标准,改良Hodge试验及组合纸片法筛查碳青霉烯酶菌株,与PCR方法检测结果进行比较并作统计学分析。结果 PCR法共检出54株携带碳青霉烯类基因,占49.5%,其中IMP型40株(IMP-4型26株,IMP-8型14株),NDM-1型4株,KPC型7株;改良Hodge试验检出碳青霉烯酶阳性菌株70株(64.2%);组合纸片法检出碳青霉烯酶阳性菌株46株,其中疑似产金属β-内酰胺酶34株(31.2%),疑似产KPC酶11株(10.1%)。以PCR方法为标准,改良Hodge试验的灵敏度和特异性分别为88.9%和60.0%;组合纸片法的灵敏度和特异性分别为57.4%和72.7%。结论改良Hodge试验和组合纸片法均适用于临床实验室,但检测结果的确证应以PCR法为准。更多还原

【Abstract】 Objective To compare the three screening methods for detection of carbapenemases,provide a basis for clinical choice for detection methods. Methods A total of 109 carbapenemse-resistant enterobacteriaceae( CRE) stored in the laboratory were collected as research object. Taking PCR as standard method,modified Hodge test( MHT) and combined paper disk method were used to screen the presence of CRE and the results of the two methods were compared with that of PCR followed by statistic analysis. Results Fifty- four strains( 49. 5%) carrying CRE gene were detected as positive by PCR,including 40 strains of IMP type( 26 strains of IMP- 4 type,14 strains of IMP-8 type),4 strains of NDM-1 type,and 7 strains of KPC-2 type; according to MHT results,70 strains( 64. 2%) were carbapenemases-positive; according to combined paper disk test,45 strains( 41. 3%) were carbapenemases- positive,including 34 strains( 31. 2%) suspected of ESBLs,11 strains( 10. 1%) suspected of KPC enzyme. Taking PCR method as standard,the sensitivity and specificity of MHT were respectively 88. 9% and 60. 0%,while the sensitivity and specificity of combined paper disk test were respectively57. 4% and 72. 7%. Conclusion MHT and combined paper disk test are both suitable for clinical laboratory,but the confirmation of the test results should be referred to PCR method.更多还原