联合苯唑西林耐药和凝固酶（CORC）试验可快速鉴定和预测血培养中金黄色葡萄球菌的苯唑西林耐药性。

The combined oxacillin resistance and coagulase (CORC) test for rapid identification and prediction of oxacillin resistance in Staphylococcus species directly from blood culture.

机构信息

Department of Microbiology, Southern General Hospital, Glasgow, Scotland, UK.

出版信息

J Clin Pathol. 2008 Jul;61(7):866-8. doi: 10.1136/jcp.2008.055681. Epub 2008 Apr 1.

DOI:10.1136/jcp.2008.055681

Abstract

The combined oxacillin resistance and coagulase (CORC) protocol for rapid identification and determination of oxacillin-susceptibility in Staphylococcus spp from blood culture is described. It incorporates a modified direct tube coagulase test (TCT) and a novel 4-hour multiplication-induction step, which increases the expression of staphylococcal PBP2a if present, facilitating detection by a commercial PBP2a latex agglutination kit. The protocol shows excellent sensitivity and specificity for determination of coagulase-positivity in staphylococci from patient blood cultures (96.8% (95% CI 81.5 to 99.8) and 100% (95% CI 75.9 to 100), respectively, n = 47), and for prediction of oxacillin resistance in S aureus directly from patient blood cultures (100% (95% CI 59.8 to 100) and 100% (95% CI 82.2 to 100), respectively (100% accuracy), n = 31) within 5 hours of blood culture positivity.

摘要

本文描述了一种联合耐苯唑西林和凝固酶（CORC）方案，用于快速鉴定和确定血培养中金黄色葡萄球菌对苯唑西林的敏感性。它结合了改良的直接试管凝固酶试验（TCT）和一个新的 4 小时倍增诱导步骤，如果存在，可增加葡萄球菌 PBP2a 的表达，从而通过商业 PBP2a 乳胶凝集试剂盒更容易检测到。该方案在鉴定来自患者血培养物中的凝固酶阳性葡萄球菌时具有出色的灵敏度和特异性（分别为 96.8%（95%CI 81.5 至 99.8）和 100%（95%CI 75.9 至 100），n=47），并且可在 5 小时内直接从患者血培养物中预测金黄色葡萄球菌对苯唑西林的耐药性（分别为 100%（95%CI 59.8 至 100）和 100%（95%CI 82.2 至 100），n=31），阳性血培养后。