【摘要】 目的 评估胶体金免疫色谱技术（GICA）在检测碳青霉烯类耐药肠杆菌目细菌（CRE）引起的血流感染早期中的应用价值，为临床CRE感染精准治疗提供实验室依据。方法 收集2020年1-12月河南省胸科医院住院患者中31份CRE标本和20份碳青霉烯类敏感肠杆菌目细菌标本，建立模拟血培养阳性实验方案，利用GICA对51份血培养阳性产物经预处理直接检测碳青霉烯酶，以聚合酶链反应测序结果作为“金标准”,评估GICA在直接检测阳性血培养标本中碳青霉烯酶分型的准确性。结果 51份血培养阳性标本中聚合酶链反应测序结果中有13株携带bla_KPC-2基因，14株携带bla_NDM-1基因，2株携带bla_NDM-5基因，2株同时携带bla_KPC-2和bla_NDM-1基因，其余20株均未检测到相应的耐药基因。GICA检测出的31份产生碳青霉烯酶的标本中13株产生bla_KPC酶，16株产生bla_NDM酶，有2株同时产生bla_KPC和bla_NDM酶。2种方法检测碳青霉烯酶分型结果一致（Kappa=1）,灵敏度、特异度均为100%。结论 GICA具有操作方便和耗时短等优点，同时，具有较高的灵敏度和特异度，可显著缩短血流感染CRE的诊断时间，可在早期为临床医生提供合理用药的实验依据。更多还原

【Abstract】 Objective To evaluate the application value of gold immunochromatographic assay（GICA） in the detection of carbapenem resistant enterobacteriaceae（CRE） in the early stage of bloodstream infection, and provide laboratory basis for the precise treatment of CRE infection.Methods A total of 31 CRE samples and 20 carbapenem-sensitive enterobacteriaceae samples were collected from inpatients in Henan Provincial Chest Hospital from January to December 2020,and a simulated blood culture positive experimental scheme was established.A total of 51 positive blood culture products were pretreated by GICA to directly detect carbapenemase, and the results of polymerase chain reaction sequencing were used as “the gold standard” to evaluate the accuracy of GICA in directly detecting carbapenemase typing in positive blood culture samples.Results The positive results of 51 blood cultures showed that 13 strains carried bla_KPC-2 genotype, 14 strains carried bla_NDM-1 genotype, two strains carried bla_NDM-5 genotype, and two strains carried both bla_KPC-2 and bla_NDM-1 genotypes.No corresponding drug resistance genes were detected in the remaining 20 strains.The 31 carbapenemase producing samples were detected by colloidal gold immunochromatography, of which 13 strains produced bla_KPC,16 strains produced bla_NDM,and two strains produced bla_KPC and bla_NDM at the same time.The results of the two methods were consistent（Kappa=1）,and the sensitivity and specificity were 100%.Conclusion GICA has the advantages of convenient operation, short time consumption, high sensitivity and specificity.This method can significantly shorten the diagnosis time of CRE in bloodstream infection, and provide experimental basis for rational drug use for clinicians in the early stage.更多还原