胶体金免疫层析法快速检测血培养肠杆菌目细菌碳青霉烯酶的对比研究

Comparative study of colloidal gold immunochromatography assay for rapid detection of carbapenemase-producing Enterobacterales in blood culture

目的评估胶体金免疫层析法快速检测血培养肠杆菌目细菌碳青霉烯酶。方法收集西安交通大学第二附属医院血培养79株肠杆菌目细菌,其中碳青霉烯类耐药肠杆菌目细菌57株和碳青霉烯类敏感肠杆菌目细菌22株,按照NG-Test CARBA 5试剂盒说明书检测待测菌株五种主要碳青霉烯酶[klebsiella pneumoniae carbapenemase(KPC)、new delhi metallo-β-lactamase(NDM)、verona integron-encoded metallo-β-lactamase(VIM)、imipenemase metallo-β-lactamase(IMP)、oxacillinase48(OXA)-48]。碳青霉烯酶基因经PCR测序确认。结果57株血培养碳青霉烯类耐药肠杆菌目细菌,NG-Test Carba 5在15 min内检测到KPC、NDM、IMP、KPC+NDM和NDM+IMP,其敏感度和特异度分别为100%和100%。金山川碳青霉烯酶耐药检测试剂检测到KPC、NDM、IMP、KPC+NDM和NDM+IMP的敏感度和特异度分别为94.74%和100%。结论NG-Test CARBA 5和金山川碳青霉烯酶耐药检测试剂作为高效和快速的诊断方法,可以简化临床检测碳青霉烯酶的复杂流程。

Objective To evaluate colloidal gold immunochromatography assay(GICA)for rapid detection of carbapenemase-producing Enterobacterales in blood culture.Methods In total,79 strains of Enterobacterales in blood culture from the Second Affiliated Hospital of Xi′an Jiaotong University were collected,including 57 carbapenem-resistant Enterobacterales and 22 carbapenem-sensitive Enterobacterales.According to NG-Test CARBA 5 kit instructions,five main carbapenemases[klebsiella pneumoniae carbapenemase(KPC),new delhi metallo-β-lactamase(NDM),verona integron-encoded metallo-β-lactamase(VIM),imipenemase metallo-β-lactamase(IMP)andoxacillinase48(OXA)-48]of the tested strains were detected.The carbapenemase gene was confirmed by polymerase chain reaction(PCR)sequencing.Results In 57 strains of Carbapenem-resistant Enterobacterales in blood culture,KPC,NDM,IMP,KPC+NDM and NDM+IMP within were detecated 15 min using NG-Test Carba 5.The sensitivity and specificity were 100%and 100%respectively.The sensitivity and specificity of KPC,NDM,IMP,KPC+NDM and NDM+IMP detected by Jinshanchuan carbapenemase resistance detection reagent were 94.74%and 100%respectively.Conclusion NG-Test CARBA 5 and Jinshanchuan carbapenemase resistance detection reagents,as efficient and rapid diagnostic methods,can simplify the complex process of clinical detection of carbapenemase.