摘要
目的分析改良Hodge试验(MHT)、Carba NP direct试验(CNPt-d)、Carba NP试验(CNPt)对碳青霉烯类非敏感类肠杆菌科细菌(CRE)检测的临床应用价值。方法收集我院2018年5月-2019年5月临床分离的碳青霉烯类非敏感类肠杆菌科细菌138株,采用聚合酶链式反应(PCR)、MHT、CNPt-d、CNPt对碳青霉烯酶耐药基因进行检测,以PCR检测为金标准,分析MHT、CNPt-d、CNPt对碳青霉烯类非敏感类肠杆菌科细菌的检测价值。结果PCR检测结果显示138株碳青霉烯类非敏感类肠杆菌科细菌共检测出含碳青霉烯酶基因的CRE120株,其中NDM-1型大肠埃希菌10株,KPC-2型肠科杆菌106株,VIM-2型肺炎克雷伯菌4株;120株碳青霉烯酶基因阳性的CRE中,有110株MHT检测结果为阳性,阳性率为91.67%;120株碳青霉烯酶基因阳性的CRE中,有115株CNPt检测结果为阳性,阳性率为95.83%;120株碳青霉烯酶基因阳性的CRE中,有120株CNPt-d检测结果为阳性,阳性率为100.00%;MHT、CNPt-d、CNPt中,CNPt-d对碳青霉烯类非敏感类肠杆菌科细菌的检测价值最高。结论MHT、CNPt-d、CNPt均能迅速检测出碳青霉烯类非敏感类肠杆菌科细菌,但CNPt-d灵敏性更强,准确性更高,且无需昂贵的蛋白抽提液,试剂成本价廉,可作为碳青霉烯类非敏感类肠杆菌科细菌的有效筛查方法。
Objective To investigate clinical application of modified Hodge test(MHT),Carba NP direct test(CNPt-d),and Carba NP test(CNPt)for detecting carbapenem-resistant Enterobacteriaceae(CRE).Methods A total of 138 strainsCRE in our hospital from May 2018 to May 2019 were collected.The carbapenemase resistance genes were detected by polymerase chain reaction(PCR),MHT,CNPt-d and CNPt,respectively.The detection value of MHT,CNPt-d and CNPt for CRE was analyzed based on the gold standard of PCR detection.Results PCR results showed that 120 carbapenase positive-genes strains were detected in 138 CRE strains,including 10 NDM-1-positive Escherichia coli,106 strains KPC-2-positive Enterobacteriaceae and 4 VIM-2-positive Klebsiella pneumoniae.Among the 120 CRE strains with positive carbapenase gene,91.67%(110/120)of them was detected by MHT,95.83%(115/120)of them was detected by CNPt,and 100.00%(120/120)of them was detected by CNPt-d.Among the three methods,CNPt-d had the highest detection value for CRE bacteria.Conclusion MHT,CNPt-d and CNPt can rapidly detect CRE bacteria,but CNPt-d is more sensitive and accurate,and the test doesn’t need expensive protein extractas well as the reagent is cheap.It might be used as an effective screening method for CRE bacteria.
出处
《实验与检验医学》
CAS
2021年第2期274-277,280,共5页
Experimental and Laboratory Medicine
基金
河南省医学科技攻关联合共建项目,编号2018020607。