MTS法与仪器MIC法检测耐碳青霉烯类肺炎克雷伯菌对替加环素敏感性的差异

发布时间：2018-04-04 14:52

本文选题：肺炎克雷伯菌　切入点：碳青霉烯类　出处：《中国感染控制杂志》2017年09期

【摘要】：目的了解耐碳青霉烯类肺炎克雷伯菌(CRKP)临床分布特点,分析菌株产酶情况及验证替加环素的体外抗菌活性。方法分析某院2015年1—12月临床患者送检标本中分离的53株CRKP的药敏结果,对目标菌株进行改良Hodge试验检测碳青霉烯酶,同时采用EDTA协同试验检测金属β-内酰胺酶,使用MIC测试条(MTS)确认仪器MIC法中替加环素药敏结果。结果 53株CRKP科室分布主要为重症监护病房(ICU)14株,占26.42%,烧伤科13株(24.53%);标本来源主要为痰23株(43.40%),创面分泌物15株(28.30%);年龄分布主要为≥60岁患者,检出35株(66.04%)。CRKP对替加环素的敏感率最高(96.2%)。经改良Hodge试验确认有48株产碳青霉烯酶,阳性率90.6%,同时15株产金属β-内酰胺酶。仪器MIC法判读为替加环素耐药的菌株经MTS法验证后均应判读为敏感。结论该院CRKP主要产碳青霉烯酶,其中部分菌株可产2类不同的β-内酰胺酶;替加环素在药敏试验中对CRKP具有良好的抗菌活性,经仪器MIC法检测为替加环素耐药的菌株须进行MTS法确认。
[Abstract]:Objective to investigate the clinical distribution of Klebsiella carbapenem-resistant Klebsiella pneumoniae (CRKP), to analyze its enzyme production and to verify the in vitro antibacterial activity of tegacycline.Methods the drug-sensitive results of 53 strains of CRKP isolated from clinical samples from January to December 2015 were analyzed. The target strains were tested for carbapenem by modified Hodge test, and metal 尾 -lactamases were detected by EDTA synergistic test.The results of tegacyclin susceptibility in MIC method were confirmed by MIC.Results the distribution of 53 strains of CRKP was mainly in intensive care unit (ICU) with 14 strains (26.42%), 13 strains of Burns (24.53%), 23 strains of sputum (23 strains), and 15 strains of wound secretions (15 strains), and the age distribution was mainly for patients aged more than 60 years.The sensitivity rate of CRKP to tegacycline was the highest (96. 2%).The improved Hodge test confirmed that there were 48 strains producing carbapenem with a positive rate of 90.6 and 15 strains producing metal 尾 -lactamases.All strains identified as tegacyclin resistance by MIC method should be identified as sensitive by MTS method.Conclusion CRKP mainly produces carbapenem, some of which can produce 2 different kinds of 尾 -lactamases, and tegacycline has good antibacterial activity against CRKP in drug sensitivity test.The strains resistant to tegacyclin were identified by MTS method by MIC method.
【作者单位】：赣州市人民医院;
【分类号】：R446.5

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