胶体金免疫层析法快速检测CRE碳青霉烯酶的效果评价

Evaluation on effectiveness of colloidal gold immunochromatography for rapid detection of CRE carbapenems

目的:分析胶体金免疫层析法对碳青霉烯酶耐药肠杆菌科细菌(CRE)产碳青霉烯酶快速检测的有效性。方法:收集蚌埠医学院第一附属医院临床分离的CRE 80株和对碳青霉烯类抗生素敏感肠杆菌科细菌21株,PCR法检测blaKPC、blaNDM、blaIMP、blaVIM、blaOXA-48耐药基因作为金标准,采用胶体金免疫层析法进行CRE产碳青霉烯酶检测,并与PCR结果进行一致性分析和效能评价。结果:80株CRE中,表达碳青霉烯酶类基因为79株,该79株经胶体金免疫层析法检测碳青霉烯酶结果均为阳性,包括61株产KPC酶、10株产NDM酶、6株产IMP酶及2株产VIM酶;21株敏感菌胶体金检测结果均为阴性;与PCR结果相比,胶体金免疫层析法对四种酶的检测敏感性与特异性均为100%,与PCR结果一致性kappa值均为1。结论:胶体金免疫层析法可快速区分CRE碳青霉烯酶类型,操作简便,具有很高的敏感度和特异性,对临床抗生素合理化用药具有重要意义。

Objective:To analyze the effectiveness of colloidal gold immunochromatography for rapid detection of carbapenemase-resistant Enterobacteriaceae(CRE)carbapenemase.Methods:A total of 80 CRE strains isolated from The First Affiliated Hospital of Bengbu Medical College and 21 strains of Enterobacteriaceae susceptible to carbapenem antibiotics were collected.PCR was used to detect blaKPC,blaNDM,blaIMP,blaVIM and blaOXA-48 genes as gold standard.Colloidal gold immunochromatography was used to detect the carbapenemase produced by CRE,which was conducted by the consistency analysis and efficiency evaluation combined with PCR results.Results:Among 80 CRE strains,79 strains expressing carbapenemase genes were all positive for the detection of carbapenemase by colloidal gold immunochromatography,which includes 61 strains producing KPC,10 strains producing NDM,6 strains producing IMP and 2 strains producing VIM enzymes,the colloidal gold test results of 21 sensitive strains were negative.Compared with the PCR results,the sensitivity and specificity of the four enzymes by colloidal gold immunochromatography were both 100%,and the Kappa value was 1.Conclusions:Colloidal gold immunochromatography can be applied as a simple,rapid,sensitive and specific diagnostic method for the detection of CRE carbapenemase,which is significant to the rationalization in the clinical use of antibiotics.