CLIN CHEM:对检测革兰氏阴性杆菌中碳青霉烯酶产生的基因型和表型方法的评价

2017-03-15 MedSci MedSci原创

产生碳青霉烯酶的革兰氏阴性细菌(CP-GNB)已经成为一种紧迫且不断扩大的公共卫生威胁。快速和准确地识别这些生物体将有利于医疗机构对感染的预防。研究表明,通过CIM初筛,进而采用Xpert Carba-R PCR复检是检测和鉴定CP-GNB,包括肠杆菌科,铜绿假单胞菌和鲍曼不动杆菌复合体在内的的一种准确的方法。

近日,临床化学杂志(Clinical Chemistry)在线发表了一篇名为Evaluation of Genotypic and Phenotypic Methods to Detect Carbapenemase Production in Gram-Negative Bacilli的文章,报道了对产生碳青霉烯酶的革兰氏阴性细菌检测基因型和表型方法的评价。

产生碳青霉烯酶的革兰氏阴性细菌(CP-GNB)已经成为一种紧迫且不断扩大的公共卫生威胁。快速和准确地识别这些生物体将有利于医疗机构对感染的预防。我们的研究的目的是评估检测和识别CP-GNB的方法。

研究人员采用3种不同的方法检测了189种碳青霉烯抗性GNBCR-GNB),包括肠杆菌科,铜绿假单胞菌和鲍曼不动杆菌复合物:2种方法为筛选生产碳青霉烯酶的GNB分离株[碳青霉烯灭活方法(CIM) 和2显色琼脂法],另外一种分子方法(Cepheid GeneXpert Carba-R)用于鉴定碳青霉烯抗性机制和相关抗性基因(blaKPCblaNDMblaIMPblaOXA-48样和blaVIM)。

结果显示,CIM是区分CR-GNBCP-GNB的一种简单且便宜的表型筛选方法,与改进的Hodge测试相比,该方法有更好的分析性能特征和读者间相关性。所评估的两种显色琼脂(HardyCHROM CREchromID CARBA)均能够支持所测试的大多数细菌的生长,包括具有类blaOXA-48基因的分离株。然而,这些培养基对碳青霉烯酶生产具有低分析特异性,且不产生碳青霉烯酶的CR-GNB能够穿透。 Xpert Carba-R试验方法是快速和易于操作的,并且和碳青霉烯抗性的遗传决定因素特征的阳性和阴性一致性均为100%。

研究表明,通过CIM初筛,进而采用Xpert Carba-R PCR复检是检测和鉴定CP-GNB,包括肠杆菌科,铜绿假单胞菌和鲍曼不动杆菌复合体在内的的一种准确的方法。

原始出处:

Allison R.McMullen,Melanie L.Yarbrough,Carey-Ann D.Burnham,et al.Evaluation of Genotypic and Phenotypic Methods to Detect Carbapenemase Production in Gram-Negative Bacilli.CLIN CHEM. Vol. 63, Issue 3 DOI:10.1373/clinchem.2016.264804

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    2017-06-22 whmdzju
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    2017-03-17 huagfeg
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    2017-03-16 1e10c84am36(暂无匿称)

    文章不错,值得分享

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