大肠埃希菌和肺炎克雷伯菌产碳青霉烯酶检测研究

the detection of carbapenemase of Escherichia coli and Klebsieila pneumoniae

目的了解大肠埃希菌和肺炎克雷伯茵产碳青霉烯酶的情况，为临床合理使用抗生素提供依据。方法收集2010年1月至2011年6月临床分离的大肠埃希茵和肺炎克雷伯菌，采用K—B纸片扩散法进行药敏试验，以厄他培南、美罗培南为检测底物进行初筛试验，采用改良Hodge试验作为表型确认试验。结果在180株大肠埃希茵和65株肺炎克雷伯菌中，以初筛试验阳性菌株数分别为14株和13株，以厄他培南为底物，确认试验阳性菌株数分别为3株和2株。产碳青霉烯酶初筛实验阳性的27株菌株经改良Hodge试验检测后有5株阳性，阳性率18．2％。结论改良Hodge试验是检测碳青霉烯酶的简便可靠方法，临床微生物实验室应常规开展改良Hodge试验，以确保药敏试验的准确性。

Objective investigate carbapenemase production of Escherichia coli and Klebsiella pneumoniae isolated from our hospital and provide basis forclinical rational use of antibiotic Methods To screen carbapenems resistance strains of Escherichia coil and Klebsiella pneumoniae with K-B method,using ertapenem and meropenem, modified Hodge test is accepted as a phenotypic confirmatory test. Results A total of 180 clinical isolates of Escherichia eoli and 65 clinical isolates of Klebsiella pneumoniae were collected from Jan 2010 to June 2011, the positive strains of screening test was 14,13 ,respectively. By using ertapenem as substrate ,modified Hodge test positive strains was respectively for the 3,2. revealed 18.2% positive rate in the modified Hodge test. Conclusion The modified Hodge test is a simple and reliable method to detect carbapenemase, it should be done to ensure the accuracy of the sensitivity test in clinical microbiology laboratory