临床分离细菌耐药性检测方法比较
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摘要
目的探讨常用的耐药检测方法以及不同药敏检测仪器对临床分离细菌耐药性的检测结果差异以及价值。方法选取地方医院微生物室中的肺炎克雷伯菌、大肠埃希菌、阴沟肠杆菌各200株,以及铜绿假单胞菌400株。通过随机抽样,将肺炎克雷伯菌、大肠埃希菌、阴沟肠杆菌样本配以不同的方法,将400株铜绿假单胞菌分配以不同的仪器中进行耐药性分析。结果纸片法和稀释法测定的3种细菌耐药性检出率差异无统计学意义(P>0.05),不同耐药检测仪器对同一细菌耐药性的检出率差异有统计学意义(P<0.05)。结论不同品牌耐药检测仪器的耐药检出率有明显差异,检测分析时应对仪器性能进行评估,在使用数据库时应注意数据的来源和可靠性。
Objective To study the differences and value of commonly used drug resistance detection methods and the detection results of different drug sensitivity detection instruments for clinical isolates.Methods A total of 200 strains of Klebsiella pneumoniae,200 strains of Escherichia coli,200 Enterobacter cloacae and 400 strains of Pseudomonas aeruginosa were collected from the local hospital.Klebsiella pneumoniae,Escherichia coli,and Enterobacter cloacae samples were assigned by random sampling to different methods,and 400 strains of Pseudomonas aeruginosa were distributed in different instruments for drug resistance analysis.Results There were no statistical significant differences in the detection rate of drug resistance between the two kinds of bacteria(P > 0.05).The detection rate of drug resistance of different instruments was statistically different.Conclusion The drug resistance detection rate of different brand drug resistance detection instruments is significantly different.The performance of the instrument should be evaluated during the test and analysis.The source and reliability of the data should be noted when using the database.
Objective To study the differences and value of commonly used drug resistance detection methods and the detection results of different drug sensitivity detection instruments for clinical isolates.Methods A total of 200 strains of Klebsiella pneumoniae,200 strains of Escherichia coli,200 Enterobacter cloacae and 400 strains of Pseudomonas aeruginosa were collected from the local hospital.Klebsiella pneumoniae,Escherichia coli,and Enterobacter cloacae samples were assigned by random sampling to different methods,and 400 strains of Pseudomonas aeruginosa were distributed in different instruments for drug resistance analysis.Results There were no statistical significant differences in the detection rate of drug resistance between the two kinds of bacteria(P > 0.05).The detection rate of drug resistance of different instruments was statistically different.Conclusion The drug resistance detection rate of different brand drug resistance detection instruments is significantly different.The performance of the instrument should be evaluated during the test and analysis.The source and reliability of the data should be noted when using the database.
引文
[1]施琛.直接药敏试验与常规药敏试验在临床血液细菌鉴定与检验中的应用价值研究[J].临床合理用药杂志,2013,6(12):5-6.
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[13]郭慧萍,曾兆欣,陈智超,等.2009-2015年凉山州第二人民医院鲍曼不动杆菌的耐药性与抗菌药物用量的相关性分析[J].现代药物与临床,2016,31(4):537-541.
[14]杨青,俞云松,孙自镛,等.2011年中国CHINET呼吸道病原菌分布和耐药性监测[J].中国感染与化疗杂志,2013,13(5):357-364.
[15]PEREZ F,ENDIMIANI A,HUJERK M.The continuing challenge of ESBLs[J].Curr Opin Pharmacol,2007,7(5):459-469.
[16]PLEBANI M.The CCLM contribution to improvement in quality and patient safety[J].Clin Chem Lab Med,2013,51(1):39-46.
[17]廖国林,李江萍,吴真,等.某院尿路感染病原菌分布及耐药性分析[J].实用药物与临床,2015,18(3):326-329.
[18]胡付品,朱德妹,汪复,等.2014年CHINET中国细菌耐药性监测[J].中国感染与化疗杂志,2015,15(5):401-410.
[19]廖国林.2009年某院细菌耐药性监测[J].国际检验医学杂志,2011,32(1):128-131.
[20]王治国,费阳,康凤凤,等.国家卫生与计划生育委员会发布临床检验专业15项医疗质量控制指标(2015年版)内容及解读[J].中华检验医学杂志,2015,38(12):777-781.
[2]庞绍新.临床血液检验中的2种不同细菌鉴定法应用分析[J].中国卫生产业,2012,10(12):152-153.
[3]刘玉庆,张怀强,胡明,等.药敏试验方法的局限性及改进的建议[J].山东大学学报(医学版),2011,49(3):124-132.
[4]邵海枫,赵旺胜.关于临床细菌耐药性检测的几点思考[J].临床检验杂志,2008,26(5):324-326.
[5]PANTOSTI A,SANCHINI A,MONACO M.Mechanisms of antibiotic resistance in Sta Phylococcus aureus[J].Future Microbiol,2007,2(3):323-324.
[6]CLSI.Performance standards for antimicrobial susceptibility testing;Twentieth Informational Supplement.2016.
[7]杨素,贺建群.K-B琼脂扩散法与微量稀释法两种药敏试验方法的比较[J].衡阳医学院学报,1998,26(2):207-208.
[8]DRIEUX L,BROSSIER F,SOUGAKOFF W,et al.Phenotypic detection of extended-spectrum beta-lactamase Production in Enterobacteriaceae review and bench guide[J].Clin Microbiol Infect,2008,14(1):90-103.
[9]DRLICA K,ZHAO X.Mutant selection window hypothesis updated[J].CID,2007,44(1):681-688.
[10]FALAGAS ME,KARAGEORGOPOULOS DE.Pandrug restistance(PDR),extensive drug resistance(XDR),and multidrug restistance(MDR)among Gram-negtive bacilli:need for international harmonization in terminology[J].Clin Infect Dis,2008,46(7):1121-1122.
[11]周庭银.临床微生物学诊断与图解[M].3版.上海:上海科学技术出版社,2012:84-86.
[12]叶应妩,王毓三,申子瑜.全国临床检验操作规程[M].3版.南京:东南大学出版社,2006:744-745.
[13]郭慧萍,曾兆欣,陈智超,等.2009-2015年凉山州第二人民医院鲍曼不动杆菌的耐药性与抗菌药物用量的相关性分析[J].现代药物与临床,2016,31(4):537-541.
[14]杨青,俞云松,孙自镛,等.2011年中国CHINET呼吸道病原菌分布和耐药性监测[J].中国感染与化疗杂志,2013,13(5):357-364.
[15]PEREZ F,ENDIMIANI A,HUJERK M.The continuing challenge of ESBLs[J].Curr Opin Pharmacol,2007,7(5):459-469.
[16]PLEBANI M.The CCLM contribution to improvement in quality and patient safety[J].Clin Chem Lab Med,2013,51(1):39-46.
[17]廖国林,李江萍,吴真,等.某院尿路感染病原菌分布及耐药性分析[J].实用药物与临床,2015,18(3):326-329.
[18]胡付品,朱德妹,汪复,等.2014年CHINET中国细菌耐药性监测[J].中国感染与化疗杂志,2015,15(5):401-410.
[19]廖国林.2009年某院细菌耐药性监测[J].国际检验医学杂志,2011,32(1):128-131.
[20]王治国,费阳,康凤凤,等.国家卫生与计划生育委员会发布临床检验专业15项医疗质量控制指标(2015年版)内容及解读[J].中华检验医学杂志,2015,38(12):777-781.