摘要
目的探讨改良Hodge试验(MHT)及改良碳青霉烯灭活试验(mCIM)检测肠杆菌科细菌金属碳青霉烯酶的应用价值。方法 VITEK 2Compact全自动细菌鉴定及药敏系统进行细菌鉴定和药敏试验,筛选2015-2017年非重复临床分离的碳青霉烯类耐药的肠杆菌科细菌,MHT及mCIM进行产碳青霉烯酶表型确证试验,PCR检测常见的金属碳青霉烯酶IMP-4、IMP-8、VIM-1、VIM-2、NDM基因。比较MHT及mCIM对肠杆菌科金属碳青霉烯酶的检测效能。结果本实验共收集40株临床分离菌株,MHT阳性36株,阳性率90.0%。mCIM阳性39株,阳性率为97.5%。PCR产物测序Blast比对证实4株为产IMP酶菌株,5株产NDM型菌株,未检测到VIM基因。MHT试验检测IMP酶的灵敏度、特异性、阳性预测值、阴性预测值分别为100.0%、11.1%、11.1%、100.0%,MHT检测NDM酶分别为40.0%、2.9%、5.6%、25.0%。mCIM检测IMP酶的灵敏度、特异性、阳性预测值、阴性预测值分别100.0%、2.8%、10.3%、100.0%,mCIM检测NDM型分别为100.0%、2.9%、12.8%、100.0%。结论 MHT及mCIM检测肠杆菌科细菌产金属碳青霉烯酶具有良好的灵敏度,但特异性偏低,应结合分子生物学方法进行检测,为感染控制提供保障。
Objective To investigate the application value of modified Hodge test(MHT)and modified carbapenem inactivation method(mCIM)for detection of metallo-carbapenemase in Enterobacteriaceae.Methods VITEK 2 Compact automatic analysis system was used to identify and test the drug sensitivity of non-repeated strains of carbapenem-resistant Enterobacteriaceae(CRE)isolated during 2015-2017.MHT and mCIM were conducted to confirm the phenotypes of carbapenemases,and PCR was used to detect common IMP-4,IMP-8,VIM-1,VIM-2 and NDM genes.The performances of MHT and mCIM in the detection of metallo-carbapenemases were compared.Results A total of 40 clinical isolates were detected.Among which 36 isolates(90.0%) were positive by MHT,while 39 isolates(97.5%) were positive by mCIM.Sequencing of PCR products and Blast confirmed that 4 strains were IMP producing strains while 5 strains were NDM producing strains;no VIM positive strains were detected.The sensitivity,specificity,positive predictive value and negative predictive value of MHT for IMP were 100.0%,11.1%,11.1% and100.0% respectively,while those for NDM were 40.0%,2.9%,5.6% and 25.0% respectively.The sensitivity,specificity,positive predictive value and negative predictive value of mCIM for IMP were 100.0%,2.8%,10.3% and 100.0% respectively,while those for NDM were 100.0%,2.9%,12.8% and100.0% respectively.Conclusion MHT and mCIM have a good sensitivity for the detection of metallo-carbapenemases in Enterobacteriaceae,but the specificity is low.It is better to use them in combination with molecular biology methods to provide guaranteed results.
作者
宫雪
张晓丽
王宇超
苏珊珊
王晓红
郭宇航
李慧玲
王勇
GONG Xue;ZHANG Xiaoli;WANG Yuchao;SU Shanshan;WANG Xiaohong;GUO Yuhang;LI Huiling;WANG Yong(Jiamusi University,Jiamusi,Heilongjiang 154007,China)
出处
《中国微生态学杂志》
CAS
CSCD
2018年第7期836-840,共5页
Chinese Journal of Microecology
基金
黑龙江省自然科学基金项目(D201224)
黑龙江省卫生计生委科研项目(2016-304)
黑龙江省大学生创新创业项目(201710222001)
佳木斯大学研究生科技创新项目(YM2016-056)