Carba NP试验检测碳青霉烯类耐药肠杆菌科细菌的临床应用
Clinical application of Carba NP test in detecting CRE strains

摘要：目的 探讨Carba NP试验检测碳青霉烯类耐药肠杆菌科细菌的临床应用。方法 收集碳青霉烯类抗生素耐药的51株肠杆菌科细菌，K-B法药敏试验检测常规药物敏感性，E-test法检测试验菌株对碳青霉烯类抗生素的最低抑菌浓度(MIC)值；分别用改良Hodge、Carba NPⅠ试验筛选碳青霉烯酶表型；然后用Carba NPⅡ试验进行碳青霉烯酶表型分类，E-test法测定金属酶，用PCR检测耐药基因。结果 41株Carba NPⅠ试验阳性且经Carba NPⅡ试验证实为产B类金属酶菌株，PCR均证实携带NDM-1基因型。 结论 Carba NP试验方便快捷、结果易于判断，与耐药基因检测符合程度高，适合实验室常规开展。
ABSTRACT: Objective To investigate the clinical application of Carba NP test in detecting carbapenem-resistant enterobacteriaceae. Methods Routine method was adopted to identify the 51 strains from clinical isolates and K-B test was conducted to screen out the carbapenem-resistant enterobacteriaceae and detect antimicrobial susceptibility. E-test was used to detect the minimum inhibitory concentration (MIC) of carbapenems. Modified Hodge test (MHT) and Carba NPⅠ test were used to screen out the phenotypes of carbapenemase, respectively. Then Carba NPⅡ test was used to classify carbapenemase which were positive in Carba NP I test. E-test was used for the detection of metalloenzymes. Polymerase chain reaction (PCR) was used for the detection of resistance genes. Results Totally 41 strains were positive in Carba NP 1 test and classified as B-class by Carba NPⅡ test. They were positive in metalloenzyme by E-test and carried NDM-1 gene by PCR. Conclusion Carba NP test can be used conveniently, has high consistency with PCR method, and the result is easy to determine. Therefore, it can be used as a routine laboratory method