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评价三种筛选方法检测超广谱β-内酰胺酶及其临床应用 被引量:158

Three screening methods for detection of extended spectrtuum β lactamases: evaluation and clinical application
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摘要 目的 评价3 种超广谱β内酰胺酶( E S B Ls) 筛选方法检测产 E S B Ls 大肠埃希菌和肺炎克雷伯菌的可靠性与临床应用。方法 以头孢三嗪、头孢噻肟、头孢他啶和氨曲南为指示底物,用双纸片协同试验、三维试验和双纸片增效试验3 种方法检测45 株 E S B Ls 阳性和64 株 E S B Ls 阴性大肠埃希菌和肺炎克雷伯菌及临床分离的74 株大肠埃希菌和31 株肺炎克雷伯菌 E S B Ls 产生情况。结果 3 种方法的敏感性分别为86 .7 % 、95 .6 % 和84 .4 % ,特异性分别为100 % 、98 .5 % 和100 % ,检测效率分别为94 .5 % 、97 .3 % 和93 .6 % 。临床分离大肠埃希菌和肺炎克雷伯菌 E S B Ls 检出率分别为32 .4 % 和25 .8 % 。头孢三嗪和头孢噻肟为本院检测 E S B Ls 最适指示底物。结论 三维试验是一种敏感、可靠的 E S B Ls 筛选方法,但操作繁琐,仅适用于标本量较少的医院;双纸片协同试验和双纸片增效试验操作简便、结果可靠,适合于各级医院常规应用。 Objectives To evaluate the reliability of three ESBLs screening methods for the detection of strains of E. coli and K. pneumoniae that produce ESBLs, and determine the prevalence in our hospital of strains producing ESBLs among E. coli and K. pneumoniae. Methods Using a set of 45 ESBLs producing and 64 non ESBLs producing strains of E.coli and K.pneumoniae , we compared three screening methods (a double disk synergy test, a three dimensional test and a double disk enhancement test) for ESBLs detection, and also determined the prevalence of strains producing ESBLs among 74 E.coli and 31 K.pneumoniae isolates from clinical samples.Results Sensitivity,specificity and agreement were found to be 86.7%, 100% and 94.5%,respectively for the double disk synergy test and 95.6%, 98.5% and 97.3% respectively, for the three dimensional test and 84.4%, 100% and 93.6% respectively, for the double disk enhancement test. The prevalence of ESBLs in isolates of E.coli and K. pneumoniae recoverd from patients in our hospital was 32.4% and 25.8 % respectively. Optimal indicators were ceftriaxone and cefotaxime for detecting ESBLs.Conclusions The most sensitive and reliable method is the three dimensional test among three screening methods for the detection of ESBLs in E.coli and K.pneumoniae. The three dimensional test was suitable for only screening strains producing ESBLs in routine in small hospital. The double disk synergy test and the double disk enhancement test are suitable for screening strains producing ESBLs in routine in all hospitals.
出处 《中华医学检验杂志》 CSCD 1999年第4期228-231,共4页
关键词 Β-内酰胺酶 大肠杆菌 克雷伯氏菌 药物筛选 beta lactamases Escherichia coli Klebsiella pneumoniae Drug resistance, microbial
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  • 1许锦民,中华医学检验杂志,1998年,21卷,373页

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