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一种用于从阳性血培养物中鉴定细菌以及mec A和van基因的快速直接检测方法的评估。

Evaluation of a rapid direct assay for identification of bacteria and the mec A and van genes from positive-testing blood cultures.

作者信息

Eigner U, Weizenegger M, Fahr A-M, Witte W

机构信息

Department of Microbiology and Hygeine, Limbach Laboratory, Robert Koch Institute, Im Breitspiel 15, D-69126 Heidelberg, Germany.

出版信息

J Clin Microbiol. 2005 Oct;43(10):5256-62. doi: 10.1128/JCM.43.10.5256-5262.2005.

Abstract

We performed the first evaluation of a DNA strip assay (GenoType blood culture; Hain Lifescience, Nehren, Germany) for the detection of the most relevant bacterial sepsis pathogens directly from positive BACTEC blood culture bottles (Becton Dickinson, Heidelberg, Germany). The test comprises two panels, one for the direct species identification of important gram-positive cocci and the other for gram-negative rods. Additionally, detection of the mec A and the van genes are implemented. The GenoType assay was validated regarding its analytical sensitivity with blood cultures spiked with reference strains. Approximately 10(4) CFU per ml were detected. Analytical specificity was calculated with a test panel of 212 reference strains. Of the strains tested, 99% were correctly identified. Additionally, 279 consecutive blood cultures signaled positive by BACTEC were processed directly, in comparison to conventional methods. The GenoType assays were performed according to Gram stain morphology. A total of 243 (87.1%) of the 279 organisms isolated were covered by specific probes. A total of 152 organisms were gram-positive cocci, of which 148 (97.4%) were correctly identified by the GenoType assay. Ninety-one organisms were gram-negative rods, of which 89 (97.8%) were correctly identified. Concerning mec A gene detection, GenoType assay correctly detected 12 of 13 methicillin-resistant Staphylococcus aureus isolates. One Enterococcus faecium isolate with a positive van A gene isolated was correctly differentiated by the assay. All results were available 4 h after the results of microscopic analysis. The evaluated GenoType blood culture assay showed fast and reliable results in detecting the most important sepsis pathogens and the mec A and van genes directly from positive blood culture bottles.

摘要

我们首次评估了一种DNA条带分析法(GenoType血培养法;德国内伦市海因生命科学公司),用于直接从阳性BACTEC血培养瓶(德国海德堡市贝克顿·迪金森公司)中检测最相关的细菌性败血症病原体。该检测包括两个检测板,一个用于直接鉴定重要的革兰氏阳性球菌,另一个用于革兰氏阴性杆菌。此外,还可检测mec A基因和van基因。通过向血培养物中添加参考菌株,对GenoType分析法的分析灵敏度进行了验证。每毫升可检测到约10⁴CFU。使用212株参考菌株的检测板计算分析特异性。在所检测的菌株中,99%被正确鉴定。此外,与传统方法相比,对BACTEC连续发出阳性信号的279份血培养物进行了直接处理。根据革兰氏染色形态进行GenoType检测。在分离出的279种微生物中,共有243种(87.1%)被特异性探针覆盖。共有152种微生物为革兰氏阳性球菌,其中148种(97.4%)通过GenoType检测被正确鉴定。91种微生物为革兰氏阴性杆菌,其中89种(97.8%)被正确鉴定。关于mec A基因检测,GenoType检测正确检测出13株耐甲氧西林金黄色葡萄球菌分离株中的12株。一株分离出的van A基因呈阳性的粪肠球菌分离株通过该检测被正确区分。所有结果在显微镜分析结果4小时后即可获得。所评估的GenoType血培养分析法在直接从阳性血培养瓶中检测最重要的败血症病原体以及mec A基因和van基因方面显示出快速可靠的结果。

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