应用VITEK-32分析仪检测细菌ESBLs酶的探讨

Discussion on Detection of Extended-Spectrum-β-Lactamases with VITEK-32

目的 探讨VITEK-32检测大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶 （ESBLs）的可靠性,分析两种菌产ESBLs的情况.方法 用VITEK-32专用药敏卡GNS-506进行ESBLs检测.用NCCLS（美国临床实验室标准化委员会标准）确证法检测ESBLs作对照.结果 仪器检测61株肺炎克雷伯菌中有17株ESBLs为阳性,用NCCLS（1999）确证法检测同样的61株肺炎克雷伯菌中有20株ESBLs为阳性;39株大肠埃希菌中,仪器检出16株阳性,用NCCLS确证法检测同样的39株大肠埃希菌中有21株ESBLs为阳性.两种方法检测结果差异无统计学意义（χ2=1.37,P〉0.05）.结论 VITEK-32检测产ESBLs菌株尚可能存在一定的局限性,故各地VITEK-32检测出产ESBLs酶的细菌,建议再用NCCLS确证法检测.

Objective To investigate the reliability of VITEK-32 for the detection of strains of E. coil and K. pneumoniae that produce ESBLs,and to determine the prevalence in their hospital of the two strains producing ESBLs. Methods VITEK GNS-506 was used to detect ESBLs,and was compared with NCCLS test. Results Among 61 strains of K. pneumoniase de- tected using VITEK GNS-506,17 strains were found to be ESBLs positive, and 20 trains ESBLs positive in the NCCLS test. The result was not consistent with that of NCCLS test. Among 39 strains of E. coli detected using VITEK GNS-506,16 strains were found to be ESBLs positive. The result was not consistent with that of NCCLS test. 21 strains were found to be ESBLs positive detected using NCCLS test （x2 = 1.37, P〉 0. 05）. Conclusion Detection of ESBLs using VITEK-32 has some limitations in the area. Simple and reliable method should be used more for detection of ESBLs suitable for routine screening.