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首页> 外文期刊>Journal of Clinical Microbiology >Detection of Colonization by Carbapenemase-Producing Gram-Negative Bacilli in Patients by Use of the Xpert MDRO Assay
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Detection of Colonization by Carbapenemase-Producing Gram-Negative Bacilli in Patients by Use of the Xpert MDRO Assay

机译：Xpert MDRO检测法检测产生碳青霉烯酶的革兰氏阴性杆菌对患者的定植

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Detecting colonization of patients with carbapenemase-producing bacteria can be difficult. This study compared the sensitivity and specificity of a PCR-based method (Xpert MDRO) for detecting blaKPC, blaNDM, and blaVIM carbapenem resistance genes using GeneXpert cartridges to the results of culture with and without a broth enrichment step on 328 rectal, perirectal, and stool samples. The culture method included direct inoculation of a MacConkey agar plate on which a 10-μg meropenem disk was placed and plating on MacConkey agar after overnight enrichment of the sample in MacConkey broth containing 1 μg/ml of meropenem. Forty-three (13.1%) samples were positive by PCR for blaKPC and 11 (3.4%) were positive for blaVIM; none were positive for blaNDM. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the PCR assay for blaKPC were 100%, 99.0%, 93.0%, and 100%, respectively, compared to broth enrichment culture and sequencing of target genes. The sensitivity, specificity, PPV, and NPV of the assay for blaVIM were 100%, 99.4%, 81.8%, and 100%, respectively. Since none of the clinical samples contained organisms with blaNDM, 66 contrived stool samples were prepared at various dilutions using three Klebsiella pneumoniae isolates containing blaNDM. The PCR assay showed 100% positivity at dilutions from 300 to 1,800 CFU/ml and 93.3% at 150 CFU/ml. The Xpert MDRO PCR assay required 2 min of hands-on time and 47 min to complete. Rapid identification of patients colonized with carbapenemase-producing organisms using multiplex PCR may help hospitals to improve infection control activities.
机译：检测产生碳青霉烯酶的细菌患者的定植可能很困难。这项研究比较了基于PCR的方法（Xpert MDRO）检测 bla KPC ， bla NDM的敏感性和特异性。使用GeneXpert弹药筒将sub>和 bla VIM 碳青霉烯抗性基因用于在328个直肠，直肠和大便样品上进行或不进行肉汤富集步骤的培养结果。培养方法包括直接接种放置有10μg美罗培南圆盘的MacConkey琼脂平板，并在含有1μg/ ml美罗培南的MacConkey肉汤中过夜富集样品后，将其接种在MacConkey琼脂上。通过PCR对 bla KPC 呈阳性的样本有43（13.1％），而对 bla VIM呈阳性的样本为11（3.4％） ; bla NDM 均无阳性。 PCR检测 bla KPC 的敏感性，特异性，阳性预测值（PPV）和阴性预测值（NPV）分别为100％，99.0％，93.0％，与肉汤富集培养和靶基因测序相比分别为100％和100％。 bla VIM 检测的灵敏度，特异性，PPV和NPV分别为100％，99.4％，81.8％和100％。由于临床样品均不含 bla NDM 的生物，因此使用三种含有 bla <的肺炎克雷伯菌分离株以不同的稀释度制备了66份人造粪便样品。 sub> NDM 。 PCR检测结果显示，在300到1,800 CFU / ml的稀释度下，阳性率为100％，在150 CFU / ml的稀释度下为93.3％。 Xpert MDRO PCR分析需要2分钟的动手时间和47分钟才能完成。使用多重PCR快速鉴定产有碳青霉烯酶的生物所定植的患者可能有助于医院改善感染控制活动。

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