万古霉素耐药折点调整对异质性万古霉素中介金黄色葡萄球菌筛选方法的影响

发布时间：2018-03-07 12:15

本文选题：金黄色葡萄球菌　切入点：万古霉素耐药　出处：《中国感染与化疗杂志》2016年04期 　论文类型：期刊论文

【摘要】：目的探讨耐甲氧西林金黄色葡萄球菌(金葡菌)(MRSA)对万古霉素耐药的折点调整后,对异质性万古霉素中介金葡菌(h VISA)的平皿筛选方法选择的影响,寻求一种敏感、有效的平皿筛选方法。方法收集临床MRSA菌株215株,分别用浓度为6 mg/L、4 mg/L、2 mg/L万古霉素脑心浸液琼脂平皿(BHIV6、BHIV4、BHIV2)及浓度为5 mg/L替考拉宁脑心浸液琼脂(BHIT5)进行h VISA筛选,同时应用菌群分析/曲线下面积(PAP/AUC)法检测h VISA,以PAP/AUC法作为金标准,对比上述4种平皿筛选方法的敏感度及特异度。结果 PAP/AUC检测h VISA的阳性菌株分别为12株,BHIV6、BHIV4、BHIV2、BHIT5筛选阳性菌株分别为6、18、54、20株;以PAP/AUC法作为金标准,上述4种平皿筛选方法灵敏度分别为41.7%、83.3%、91.7%、83.3%,特异度分别为99.0%、95.9%、77.8%、94.8%。结论 MRSA对万古霉素耐药折点调整后,BHIV6筛选法灵敏度较低、BHIV2筛选法特异度较低,不应作为h VISA的筛选方法,BHIV4和BHIT5平皿筛选法灵敏度和特异度均较高,可作为万古霉素耐药折点调整后对h VISA的常规筛选方法。
[Abstract]:Objective to investigate the effect of MRSA-resistant to vancomycin-resistant Staphylococcus aureus (MRSAs) on the selection of a pandish screening method for heterogeneous vancomycin-mediated staphylococcus aureus (h VISAs), and to find a sensitive method for the screening of vancomycin-resistant Staphylococcus aureus. Methods 215 strains of clinical MRSA strains were collected and screened with 6 mg / L 4 mg / L ~ (2) mg/L vancomycin brain extract (Agar) and 5 mg/L teicolanine brain heart extract (Agar BHIT5) and the concentration of 5 mg/L teicolanine (Agar BHIT5), respectively. At the same time, the method of microflora analysis / area under curve was used to detect hVISA.The PAP/AUC method was used as the gold standard. The sensitivity and specificity of the four screening methods were compared. Results the positive strains of h VISA detected by PAP/AUC were 12 strains of BHIV6, BHIV4, HIV2, HIV2, BHIT5, respectively, and 20 strains were screened by PAP/AUC as gold standard. The sensitivity of the four screening methods were 41.7 and 83.37, and the specificity was 99.00.95. 9 and 77.80.Conclusion the sensitivity of MRSA in screening vancomycin resistant to vancomycin was lower than that of BHIV6, and the sensitivity of HIV6 screening was lower than that of BHIV6, and the specificity was 99.09.90.Conclusion the sensitivity of MRSA for vancomycin resistant screening was lower than that of BHIV6. It should not be used as a screening method for h VISA. Both HIV4 and BHIT5 plate screening methods have higher sensitivity and specificity. They can be used as routine screening methods for h VISA after adjusting vancomycin resistance point.
【作者单位】：山东省滨州市人民医院内科;
【基金】：山东省医药卫生发展计划(2014WS0310)
【分类号】：R446.5

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