Jeong Seok Hoon, Song Wonkeun, Park Min-Jeong, Kim Jae-Seok, Kim Han-Sung, Bae Il Kwon, Lee Kyu Man
Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Int J Antimicrob Agents. 2008 May;31(5):467-71. doi: 10.1016/j.ijantimicag.2007.12.014. Epub 2008 Mar 11.
A study using boronic acid (BA) was designed to detect the extended-spectrum beta-lactamases (ESBLs) in Enterobacteriaceae producing chromosomal AmpC beta-lactamases. A total of 197 clinical isolates of Enterobacter spp. (n=100), Serratia marcescens (n=62) and Citrobacter freundii (n=35) were analysed. Genes encoding ESBLs were detected by polymerase chain reaction (PCR) amplification followed by direct sequencing of PCR products. The Clinical and Laboratory Standards Institute confirmatory test detected only 72.1% of the ESBL-producing isolates. When a > or =5mm increase in the zone diameter of either the cefotaxime/clavulanic acid and/or the ceftazidime/clavulanic acid disks tested in combination with BA versus cefotaxime and/or ceftazidime containing BA was considered to be a positive for ESBL, the method detected 60 (98.4%) of the 61 isolates that harboured ESBLs and showed no false-positive results for ESBL-non-producing isolates. In conclusion, the BA disk test is a highly sensitive and specific method for the detection of ESBLs in Enterobacteriaceae producing chromosomal AmpC beta-lactamases.
一项使用硼酸（BA）的研究旨在检测产染色体AmpCβ-内酰胺酶的肠杆菌科细菌中的超广谱β-内酰胺酶（ESBLs）。共分析了197株临床分离的肠杆菌属（n = 100）、粘质沙雷氏菌（n = 62）和弗氏柠檬酸杆菌（n = 35）。通过聚合酶链反应（PCR）扩增，随后对PCR产物进行直接测序来检测编码ESBLs的基因。临床和实验室标准协会的确认试验仅检测出72.1%的产ESBLs分离株。当将头孢噻肟/克拉维酸和/或头孢他啶/克拉维酸纸片与含BA的纸片联合检测时，若头孢噻肟和/或头孢他啶含BA的抑菌圈直径增加≥5mm被视为ESBL阳性，则该方法检测出61株携带ESBLs的分离株中的60株（98.4%），且对不产ESBLs的分离株未显示假阳性结果。总之，BA纸片试验是检测产染色体AmpCβ-内酰胺酶的肠杆菌科细菌中ESBLs的一种高度敏感和特异的方法。
