检测肺炎克雷伯菌中的超广谱β-内酰胺酶：表型特征分析方法比较。
Detection of extended-spectrum β-lactamases in Klebsiella pneumoniae: comparison of phenotypic characterization methods.
机构信息
Hasan Ejaz, M.Phil, Institute of Industrial Biotechnology, GC University, Lahore, Pakistan.
Ikram-ul-Haq, PhD, Institute of Industrial Biotechnology, GC University, Lahore, Pakistan.
出版信息
Pak J Med Sci. 2013 May;29(3):768-72. doi: 10.12669/pjms.293.3576.
OBJECTIVE
Extended-spectrum β-lactamase producing K. pneumoniae is a serious threat to the patients. This manuscript shows the comparison of phenotypic characterization methods used for ESBL K. pneumoniae and frequency distribution of these isolates in various clinical samples.
METHODOLOGY
Eleven different types of pathological samples collected on various time intervals were analyzed. K. pneumoniae were identified with API 20E system (bioMerieux) and initial screening of ESBL K. pneumoniae was performed using the ceftazidime antimicrobial disc. Double-disc synergy test (DDST) and CLSI confirmatory test were compared for the phenotypic detection of ESBL K. pneumoniae.
RESULTS
A total number of 214 ESBL producing K. pneumoniae were isolated from various clinical samples. Frequency distribution of ESBL producing K. pneumoniae was found to be highest among blood 117 (54.7%) and urine 46 (21.5%) samples. Data regarding the use of various interventions among these patients showed most common presence of intravenous line 209 (97.7%) and urinary catheters 46 (21.5%). Comparison of DDST and CLSI confirmatory test showed that the DDST detected 145 (67.8%) isolates while 213 (99.5%) ESBL K. pneumoniae were characterized by CLSI confirmatory test.
CONCLUSION
The use of CLSI confirmatory test is very efficient in the early detection of ESBL K. pneumoniae especially when the facilities for molecular characterization are not available.
目的
产超广谱β-内酰胺酶的肺炎克雷伯菌对患者构成严重威胁。本文展示了用于检测产超广谱β-内酰胺酶肺炎克雷伯菌的表型特征方法的比较，以及这些分离株在各种临床样本中的频率分布。
方法
分析了在不同时间间隔收集的 11 种不同类型的病理样本。使用 API 20E 系统（生物梅里埃）鉴定肺炎克雷伯菌，并使用头孢他啶抗菌盘进行初始产超广谱β-内酰胺酶肺炎克雷伯菌的筛选。比较了双碟协同试验（DDST）和 CLSI 确认试验，以对产超广谱β-内酰胺酶肺炎克雷伯菌进行表型检测。
结果
从各种临床样本中分离出 214 株产超广谱β-内酰胺酶的肺炎克雷伯菌。产超广谱β-内酰胺酶的肺炎克雷伯菌的频率分布在血液样本中最高，为 117 株（54.7%），尿液样本中为 46 株（21.5%）。对这些患者使用各种干预措施的数据显示，最常见的是静脉置管 209 例（97.7%）和导尿管 46 例（21.5%）。DDST 和 CLSI 确认试验的比较结果显示，DDST 检测到 145 株（67.8%）分离株，而 CLSI 确认试验则鉴定出 213 株（99.5%）产超广谱β-内酰胺酶的肺炎克雷伯菌。
结论
当没有分子特征化的设施时，CLSI 确认试验在早期检测产超广谱β-内酰胺酶的肺炎克雷伯菌方面非常有效。
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