【摘要】 目的 探讨三种方法对肠杆菌科细菌产碳青霉烯酶进行筛选时的临床价值。方法 54株肠杆菌科细菌,均给予改良碳青霉烯酶灭活试验(mCIM)联合EDTA碳青霉烯失活试验(eCIM)、酶抑制剂增强试验、快速碳青霉烯酶检测方法 (rCDM)进行筛选。以聚合酶链式反应(PCR)结果为金标准,比较三种方法筛选肠杆菌科细菌产碳青霉烯酶的灵敏度、特异度及检测时长。结果 54株肠杆菌科细菌经PCR筛查, 36株为阳性, 18株为阴性。rCDM法筛选肠杆菌科细菌产碳青霉烯酶的灵敏度、特异度分别为88.89%、94.44%,均高于mCIM联合eCIM法的50.00%、50.00%和酶抑制剂增强试验的66.67%、55.56%,差异具有统计学意义(P<0.05)。rCDM法的检测时长为(0.32±0.10)d,短于mCIM联合eCIM法的(1.21±0.25)d、酶抑制剂增强试验的(0.56±0.22)d,差异具有统计学意义(P<0.05)。结论 在对肠杆菌科细菌产碳青霉烯酶进行筛选时,应用rCDM筛选的效果和效率较好,值得临床推广。更多还原

【Abstract】 Objective To discuss the clinical value of three methods in screening carbapenemaseproducing Enterobacteriaceae. Methods 54 strains of Enterobacteriaceae were screened by modified carbapenem inactivation method(mCIM) combined with EDTA-carbapenem inactivation method(eCIM), enzyme inhibitor enhancement test and rapid carbapenase detection method(rCDM). The results of polymerase chain reaction(PCR) were used as the gold standard to compare the sensitivity, specificity and detection time of the three methods for screening carbapenemase-producing Enterobacteriaceae. Results 54 strains of Enterobacteriaceae were screened by PCR, 36 strains were positive and 18 strains were negative. The sensitivity and specificity of r CDM for screening carbapenemase-producing Enterobacteriaceae were 88.89% and 94.44%, which were higher than those of 50.00% and 50.00% of mCIM combined with eCIM, and those of 66.67% and 55.56% of enzyme inhibitor enhancement test. The differences were statistically significant(P<0.05). The detection time of rCDM was(0.32±0.10) d, which was shorter than that of(1.21±0.25) d of mCIM combined with eCIM, and that of(0.56±0.22) d of enzyme inhibitor enhancement test, and the differences were statistically significant(P<0.05).Conclusion In the screening of carbapenemase-producing Enterobacteriaceae, the screening quality and efficiency of rCDM good, and is worthy of clinical promotion.更多还原