發(fā)布時(shí)間：2018-04-05 09:09

  本文選題：基質(zhì)輔助激光解析電離飛行時(shí)間質(zhì)譜　切入點(diǎn)：產(chǎn)碳青霉烯酶　出處：《中國(guó)感染與化療雜志》2016年05期

【摘要】：目的應(yīng)用基質(zhì)輔助激光解析電離飛行時(shí)間質(zhì)譜(MALDI-TOF MS)檢測(cè)產(chǎn)KPC-2、NDM-1、VIM-2、IMP-1與IMP-4型碳青霉烯酶腸桿菌科細(xì)菌水解厄他培南的能力。方法收集2009年6月-2013年12月上海交通大學(xué)醫(yī)學(xué)院附屬新華醫(yī)院各種臨床標(biāo)本中分離的耐碳青霉烯類腸桿菌科細(xì)菌(CRE),用改良Hodge試驗(yàn)進(jìn)行產(chǎn)碳青霉烯酶的表型篩選,用PCR擴(kuò)增方法檢測(cè)其碳青霉烯酶基因,并經(jīng)測(cè)序確認(rèn)。應(yīng)用MALDI-TOF MS進(jìn)行厄他培南水解預(yù)試驗(yàn)以確定最適厄他培南濃度及孵育時(shí)間,隨后采用預(yù)試驗(yàn)中的最適條件,應(yīng)用MALDI-TOF MS檢測(cè)CRE水解厄他培南的能力。結(jié)果 108株CRE中,有102株改良Hodge試驗(yàn)陽性,其中90株產(chǎn)KPC-2、4株產(chǎn)NDM-1、3株產(chǎn)VIM-2、2株產(chǎn)IMP-1、2株產(chǎn)IMP-4、1株同時(shí)產(chǎn)KPC-2和IMP-4型碳青霉烯酶,且在2 h內(nèi)均能水解厄他培南;另外6株CRE改良Hodge試驗(yàn)陰性,未檢測(cè)出上述碳青霉烯酶基因,且不水解厄他培南。結(jié)論臨床微生物實(shí)驗(yàn)室應(yīng)用MALDI-TOF MS能夠快速準(zhǔn)確檢測(cè)CRE水解厄他培南的能力,篩查產(chǎn)碳青霉烯酶腸桿菌科細(xì)菌,為臨床早期合理使用碳青霉烯類抗生素提供依據(jù)。
[Abstract]:Objective to detect the ability of KPC-2NdM-1 (VIM-2) IMP-1 and IMP-4 type carbapeninase enterobacteriaceae bacteria to hydrolyze ertapenem by matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS).Methods from June 2009 to December 2013, a series of clinical specimens from Xinhua Hospital affiliated to Shanghai Jiaotong University Medical College were collected, and the phenotypic screening of carbapenem producing enzymes was carried out by modified Hodge test, which was isolated from various clinical specimens of Enterobacteriaceae, Shanghai Jiaotong University.The carbapenem gene was detected by PCR and confirmed by sequencing.The optimal concentration and incubation time of etapenem were determined by using MALDI-TOF MS to determine the optimal concentration and incubation time. Then, the ability of CRE hydrolysis of ertapenem was detected by MALDI-TOF MS.Results of the 108 CRE strains, 102 were positive for modified Hodge test, 90 of which produced KPC-2P 4 strains and NDM-1 + 3 strains, and 2 strains produced IMP-1 and 2 strains produced both KPC-2 and IMP-4 carbapenem, and were able to hydrolyze ertapenem within 2 hours.The other 6 strains were negative in CRE modified Hodge test and did not detect these carbapenase genes and did not hydrolyze ertapenem.Conclusion MALDI-TOF MS in clinical microbiology laboratory can quickly and accurately detect the ability of CRE to hydrolyze ertapenem and screen Enterobacteriaceae bacteria producing carbapenem so as to provide evidence for the rational use of carbapenem antibiotics in early clinical stage.
【作者單位】： 上海交通大學(xué)醫(yī)學(xué)院附屬新華醫(yī)院檢驗(yàn)科臨床微生物室;
【分類號(hào)】：R446.5

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